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Vildagliptin appears to have a neutral effect, while saxagliptin has a negative effect on bone, increasing osteoclastic activity and decreasing osteocytic and osteoblastic activity in the femur in preclinical studies [108, 109, 109]
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A slower, more gradual dose escalation as is standard practice with GLP-1-based therapies may help mitigate the intensity and duration of tiredness
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