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Advise patients that they will need to be monitored to see if impaired glucose tolerance or diabetes mellitus develops, and that if they have pre-existing diabetes mellitus, they may need adjustments to their anti-diabetic medications [see Warnings and Precautions (5.4)]

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In addition, Lactobacillus can produce indole-3-aldehyde, which acts on aryl hydrocarbon receptor (AhR) and activates leukocytes

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