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These include: Lack of efficacy: Despite the medications effectiveness for many individuals, it may not produce the desired blood sugar control or weight loss in some cases

Lincoffs comment is important, as the growth and refinement of bariatric (metabolic) surgery over the past 30 years has resulted in significant gains for many patients, not just in life span and quality of life but also in reversal of diabetes and reduction of diabetes risk as well as compelling evidence suggesting cardiovascular benefits

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