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Indeed, many of the traditional CVD risk factors, including oxidized low-density lipoprotein[313], hyperlipidemia (hypercholesterolemia or mixed dyslipidemia)[314] insulin resistance[309, 310, 312], diabetes[315], obesity[309, 311], elevated C-reactive protein[316], waist-to-hip ratio[309], reduced coronary flow reserve[279], smoking[317], sedentary life[318] and psychological distress[319], which act via effects on endothelial dysfunction, apoptosis and impaired endothelial-dependent vascular reactivity, have been associated with low serum IGF-I levels and reduced IGF-I and IGF-IR mRNA as well as protein expression in vascular smooth muscle cells (VSMC)[313]

5 years of Farxiga usage: Weight loss: 5-8 pounds (maximum amount achievable) Total costs: $30,000 to $36,000 (self-pay) or $1,500 to $6,000 (with insurance coverage) Side effects: Permanent UTIs, recurring yeast infections, increased dehydration risk Outcome after discontinuation: Weight gain back within 3 to 6 months Elimination of diabetes: 0% only possible through managing symptoms Frequency: Every day for years (and potentially a lifetime) Bariatric surgery (one-time surgical procedure): Weight loss: 60-80% of excess body weight Total costs: $15,000 to $25,000 (self-pay), or insurance coverage is often available Side effects: Recovery period post-surgery (2-4 weeks) Long-term outcome: Physiological change
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