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SYNERGY Mechanistic studies show that joint activation of both pathways is associated with GH release many times higher than each component alone additive cAMP/Ca2+ signaling and enhanced somatotroph responsiveness
65,66,67 Although the risk factors for PDPN are poorly understood, female sex, longer diabetes duration, increased neuropathy severity, renal dysfunction, higher HbA1c levels, and higher BMI have been suggested as contributing factors
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