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There is supporting evidence reporting adverse effects from long-term rhIGF-1 treatment including neoplastic formation, cataract and renal hypertrophy, all of which seem to be the most severe effects observed and are usually rare [123, 282284]

Transient potassium replacement at the initial stage of vitamin B 12 replacement, especially in those with low-normal serum potassium, can prevent subsequent hypokalaemia

This prevents the development of lipohypertrophy, which is a buildup of fatty tissue that can interfere with medication absorption

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