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The Journal of Clinical Endocrinology & Metabolism, 2015

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Ertugliflozin plus sitagliptin versus either individual agent over 52 weeks in patients with type 2 diabetes mellitus inadequately controlled with metformin: The VERTIS FACTORIAL randomized trial

Some patients get paradoxical fatigue or headaches from B12 due to detoxification effects, in which case lower your dose

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Because the drug builds up in the body over time, noticeable effects like appetite changes and weight loss often take longer