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Under the action of unhealthy metabolic factors (obesity, diabetes), ER stress is initiated, and IRE-1 is activated, which in turn leads to the phosphorylation of IRS1 at the serine 307 residue by activating JNK, thereby impairing insulin signaling

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Common adverse effects include gastrointestinal symptoms such as nausea, vomiting, diarrhea, and constipation, which are generally mild to moderate and diminish over time

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