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It also increases insulin resistance and hepatic glucose production, frequently leading to impaired glucose tolerance or diabetes

Rather than swapping in a shake to deliberately cut calories, it's often used simply to help meet nutritional needs on the day's appetite is naturally low, since it can be genuinely hard to get enough nutrition in when you're just not hungry

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The great heterogeneity could indicate significant differences among the included studies, which could be due to different population aspects, a study design, the type of the GLP-1 RAs that were used, or intervention durations