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Activation of IR and IGF1R by their cognate ligands initiates a cascade of phosphorylation events beginning with a conformational change of the receptors leading to autophosphorylation and the recruitment and phosphorylation of substrates such as IRS-1 and Shc proteins (46)

Sample size estimation Sample size was estimated to show, with a power of 80%, a 13% stronger decrease in the primary endpoint under dulaglutide as compared with placebo

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