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SGLT2 inhibitors were chosen as the comparator given they are guideline-recommended second-line glucose-lowering medication and share similar cardiovascular benefits with GLP-1RA, which helps reduce confounding by indication

Two possibilities explain the animal oral data: Local action without systemic absorption: BPC-157 at high luminal concentrations acts directly on GI epithelium, submucosal vessels, and enteric neurons without requiring absorption into the bloodstream

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