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This situation underscores the need for further research to characterize global pediatric usage as well as the nuances of prescribing these medications across clinical contexts

The advancement of biosimilars and more economical production techniques may alleviate these issues

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In select cases particularly patients with: Obesity High insulin resistance Very high total daily insulin requirements endocrinologists may consider off-label use with: Continuous glucose monitoring Routine ketone monitoring Strict sick-day protocols Close specialist follow-up But this is not standard therapy