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Then I found MDWatch

The prescribed concentration and dose are determined by the treating clinician and dispensing pharmacy

These drugs work by increasing insulin release, suppressing glucagon release, and promoting satiety, among other effects

Insulin was quantified using a Beckman Coulter Access 2 Analyzer Immunoassay System, and insulin secretion was expressed as total intracellular content normalised to baseline

Its likely due to an indirect effect of the medication reducing appetite to a point where people dont eat enough, and their bodies enter starvation mode whereby metabolism effectively grinds to a halt to ensure sufficient energy delivery to vital organs