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References: Proksch et al

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The hormone promotes gluconeogenesis (glucose production) in the liver and reduces glucose uptake in peripheral tissues, creating an insulin-resistant state

Instead, it inhibits an enzyme called NNMT, which shifts cell metabolism toward fat oxidation and muscle preservation

Hyperdiuresis did need to be discontinued prematurely in two patients (in one case due to a rise in sodium from 120 mM to 128 mM, in another patient due to hypertension)