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however, subsequent evidence indicates that most GLP-1mediated hepatic effects are indirect, driven by reductions in caloric intake, body weight, and insulin resistance [77]

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L-arginine undergoes significant first-pass metabolism in the intestines and liver

Another study assessing the addition of GLP-1 analogues (liraglutide or exenatide) to existing insulin therapy in type 2 diabetes patients showed reductions in HbA1c, body weight and insulin dosage

Lab follow-up helps show whether the schedule is correcting deficiency and whether ongoing maintenance is needed