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"My hypothesis, with anecdotal evidence, is when someone who hasn't been fit becomes fit, starts becoming fit, they change their life to make sure they're protecting and truly being fit," Siegel said

[9] To be able to confirm possible cardiovascular benefits of DPP-4 inhibitors requires large, double-blind, randomized trials with formal adjudication of cardiovascular end points

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Bottom line SURMOUNT-4 ended the course-of-treatment story