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Perhaps most convincingly, rat studies in which plasma glucose and lactate levels were measured in the inferior vena cava, hepatic vein, hepatic portal vein and the aorta demonstrated that the plasma lactate concentration peaks in the hepatic portal vein, with a corresponding drop in the plasma glucose concentration

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Patients on anticoagulants (warfarin, apixaban) or antiplatelet agents (aspirin, clopidogrel) should discuss injection timing with their provider, as these increase bruising risk without affecting pain acuity

This assessment may include lab work and identification of health gaps to address alongside weight loss goals