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The higher rates in the diabetes population likely reflect the baseline GI motility alterations common in type 2 diabetes (diabetic gastroparesis, autonomic neuropathy) and the potential for additive GI effects with concomitant metformin use

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I use the 500 mcg dot, but I know they also make a 5000 mcg dot

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First, when you take a pill, it has to be digested and metabolized through the liver or kidney through what is called the first-pass effect