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Insulin receptors are extensively distributed throughout but are particularly abundant in regions such as the olfactory bulb, cerebral cortex, hippocampus, hypothalamus, and cerebellumareas integral to learning, memory, and emotional regulation [96]

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This is a hard contraindication, not a caution

In February 2020, Trulicity was approved by the US FDA for new indications for use in adult patients with type 2 diabetes who have cardiovascular (CV) diseases or multiple cardiovascular risk factors to reduce the risk of major adverse cardiovascular events (MACE)