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Metabolic Very common (10% or more): Hypoglycemia (up to 29.8%), decreased appetite (up to 14%) Common (1% to 10%): Severe hypoglycemia Hypoglycemia (blood glucose less than 54 mg/dL or 3 mmol/L) has commonly been reported in patients with type 2 diabetes

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it can also influence the nucleus of the cell to alter gene activity