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Impaired Hepatic Function Since impaired hepatic function has been associated with some cases of lactic acidosis, Janumet should generally be avoided in patients with clinical or laboratory evidence of hepatic disease

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The International Hypoglycaemia Study Group (2019) Hypoglycaemia, cardiovascular disease, and mortality in diabetes: epidemiology, pathogenesis, and management

This increase was accompanied by a 50% decrease in glucose usage during low intensity exercise, and muscle lactate build up was reduced by 44%