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Horm Res Paediatr (2016) 86(6):36197

Cardiologists recommended combined therapy for patients with established cardiovascular disease or high cardiovascular risk who were already on treatment with one of the two drugs and had an HbA1c above target

Lancet 390 , 15501562 (2017)

Among the main obstacles are the complicated interactions between genetic and environmental variables, poor adherence to lifestyle modifications, and restricted access to therapies, especially in low- and middle-income countries