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A companion study from the Karolinska Institutet in Sweden, published on the same day, reached a broadly similar conclusion, and found that the association weakened once background treatment was taken into account

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Efficacy and safety of insulin in type 2 diabetes: meta-analysis of randomised controlled trials

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acute conditions associated with a risk of renal impairment, such as dehydration (due to diarrhea, vomiting), fever, severe infectious diseases, hypoxic conditions (shock, sepsis, renal infections, bronchopulmonary diseases)

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