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During this procedure a tendon from the big toe is removed and transferred to the back of the heel to reinforce the damaged Achilles tendon

While this effect appears to be related to the magnitude and rapidity of glucose lowering rather than a direct effect of the medication itself, patients with a history of diabetic retinopathy should undergo careful ophthalmologic evaluation before and during treatment, and the potential risks should be weighed against the expected benefits of improved glycemic control