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References Aronne LJ, Horn DB, le Roux CW, et al

F., Alharbi, T

This phenomenon, sometimes referred to as early worsening of diabetic retinopathy, appears to be related to the magnitude and speed of glucose lowering rather than a direct effect of the medication

The crucial distinction from ghrelin is timescale

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A potential explanation for these divergent effects is that ghrelin may increase motivation via dopamine transmission in the VTA, yet may also act in other regions to decrease competing motivation for non-food motives 92