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DES(1-3) IGF-1 is a truncated variant missing the first three N-terminal amino acids (Gly-Pro-Glu), which also reduces IGFBP binding but through a different structural mechanism removal of the N-terminal tripeptide rather than charge substitution

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21:188-193 [PubMed: 30058208] 363

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However, an overview of our current understanding of GB physiology may provide some important insights

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Yes, GLP-1 medications can cause fatigue in some patients, though severity and timing vary significantly

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