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Upon DNA-dependent transactivation (TA), GR dimers bind to GC-responsive elements, followed by transcriptional activation of genes associated with an increased risk of adverse effects including diabetes mellitus, peptic ulcer, Cushings syndrome, osteoporosis, hyperglycemia, skin and muscle atrophy, and many other complications [12]

Reaching peak plasma levels within 3060 minutes instead of the 46 hours typical of oral supplementation

7 8 Both drugs have known limitations and side-effect profiles, and neither cures the condition benefits generally require continued use