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The clinical use track record in Eastern Europe and Asia provides a level of real-world safety and efficacy data that purely preclinical peptides lack, though large-scale randomized controlled trials specifically for peripheral neuropathy are still needed

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Two honest caveats

Patients should never alter their dose independently in response to side effects without consulting their healthcare provider

"DPP-4 Inhibitors for Type 2 Diabetes: Drug Safety Communication - May Cause Severe Joint Pain"