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Smaller doses tend to lead to fewer side effects, which is why doctors usually start patients on low GLP-1 doses

doi: 10.1016/j.cyto.2009.08.010 166 LiS.ZhaoF.YeJ.LiK.WangQ.DuZ.et al

This decision dates back to Medicare Part Ds creation in 2003 when their safety and effectiveness were questioned, leading to a ban in coverage that remains today