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It just means that sometimes, progress looks different from what we expected

Ziats MN, Comeaux MS, Yang Y, et al

References Hanahan D, Weinberg RA

Hypoglycaemia: Risk is low with GLP-1 monotherapy but increases when combined with insulin or sulphonylureas

Notably, individuals at the extremes of age, both infants and the elderly, as well as those with pre-existing comorbidities, particularly cardiopulmonary disorders, are at markedly increased risk (490)