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In the presence of the incretin hormone glucagon-like peptide-1 (GLP-1), which stimulates the proinsulin gene promoter, leptin inhibits the GLP-1-induced expression of preproinsulin mRNA in human islets (Seufert, 2004)
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Thus, no evidence currently indicates that patients with HFrEF benefit from the administration of GLP-1RAs, but rather, the increased arrhythmias and death are concerning
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