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What specific clinical evidence supports using this combination over plain tirzepatide

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Chronic GLP-1 receptor activation by Exendin-4 induces expansion of pancreatic duct glands in rats and accelerates formation of dysplastic lesions and chronic pancreatitis in the Kras G12D mouse model

There are several ways one can develop these patches such as hormonal changes, exposure to UV rays, trauma to skin or medications that can cause sunlight changes.Thyroid disorders or natural ageing could also be the reason behind these patches at times