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Pooling was also considered potentially misleading because large effect estimates from selected realworld cohorts may have been amplified by selection and attrition, and because effect estimates for glycaemic outcomes and insulin reduction may reflect a mixture of direct drug effect, mediated weightloss effects, technology use, and cliniciandriven insulin retitration

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Insulin resistancea condition where cells become less responsive to insulinis a key driver of type 2 diabetes and metabolic syndrome