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As Case 2 demonstrated, a patient may tolerate one drug in the class (semaglutide) but not another (tirzepatide), suggesting the reaction may be specific to certain agents or their unique pharmacologies
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5,6 Additionally, high glucose levels negatively impact osteoblast function, contributing to bone defects partly through the production of advanced glycation end-products (AGEs), which upregulates sclerostin, an inhibitor of osteoblast activity
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