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This phenomenon is also not thought to be a direct toxic effect of the drug itself, but rather a known risk associated with rapid and substantial improvement in glycemic control, which can also be observed with the initiation of intensive insulin therapy

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It is important to note that many individuals taking Mounjaro for diabetes may have pre-existing risk factors for gastro-oesophageal reflux disease (GORD), including obesity, dietary habits, and hiatus hernia