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Because GLP-1 medications reduce appetite appetite signal, patients may unintentionally consume fewer minerals and micronutrients essential for energy production

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22 However, the fact that the magnitude and speed of hemoglobin A1c reduction with treatment were identified as risk factors for progression suggests it could be another example of the well-established early worsening phenomenon first observed in type 1 diabetic patients intensively treated with insulin in the Oslo Study, Kroc Collaborative Study and Diabetes Control and Complications Trial

New England Journal of Medicine , 375 (19), 1834-1844