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Glucose-lowering effects are mediated by the stimulation of insulin release and the suppression of glucagon secretion, with a low risk of hypoglycemia [21]

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Under normal physiological conditions, nutrients in the gut stimulate the release of GLP-1 and GIP, leading to increased insulin secretion and decreased glucagon release from the pancreas in a glucose-dependent manner [22]

Some surgeons argue that amputation should be the procedure of choice when possible, due to the increased chance of a better quality of life

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