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The 3 "Bold" Shifts You Need to Know: 1 The New Baseline: Dual Therapy from Day 1 For most peopleeven those without comorbiditiesthe recommendation is now Metformin AND an SGLT2 inhibitor as first-line treatment

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While the research base for microdosing, specifically, is still developing, and lower-dose protocols are being explored, though clinical evidence for efficacy at sub-therapeutic doses remains limited

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This is partly due to the negative effect of diabetes on the immune system, but its also partly due to the role sugar plays in managing vaginal bacteria