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Visceral fat and IGF-1 are meaningful measures, but they are surrogate/intermediate endpoints, not hard clinical outcomes like cardiovascular events

this effect persists during brief interruptions

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[1] Monitoring in diabetes : Patients with diabetes who are taking insulin or sulfonylureas should monitor their blood glucose levels closely when starting ispaghula, as improved glycaemic control may necessitate adjustments to these medications

Nat Rev Endocrinol 8(12):728742