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Infection An uncommon complication reported rate of ~ 0.2%

Tom-Castro XM, Rodriguez-Arrastia M, Cardona D, Rueda-Ruzafa L, Molina-Torres G, Roman P

Shedding of dipeptidyl peptidase 4 is mediated by metalloproteases and up-regulated by hypoxia in human adipocytes and smooth muscle cells

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Soluble fiber sources like apples, pears, oats, and beans are particularly effective at stimulating GLP-1 secretion, which complements the medication's effect