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The release of insulin and glucagon in the pancreas can be regulated by various receptors (Holst 2007)

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It should generally be avoided if you are pregnant, breastfeeding, or have a history of: Severe gastrointestinal disease, Pancreatitis, Certain endocrine or thyroid conditions

However, when combined with insulin or sulfonylureas, the risk increases significantly, and dose adjustments of these medications may be necessary

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Diabetic Ketoacidosis Associated With Adrenocorticotropic Hormone-Producing Pituitary Adenoma