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The institutional ethics review board of Shanghai Ninth Peoples Hospital, Shanghai Jiao Tong University School of Medicine approved this study (Approval # 2016-179-T123)

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Approximately 10-15% of users experience mild redness, swelling, or tenderness at injection sites, typically resolving within 24-48 hours

Blood glucose can remain normal while insulin rises steadily to compensate, until the system finally fails and type 2 diabetes or metabolic syndrome emerges

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