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Rates of vaccination are relatively low among high-risk populations (eg, illicit IV drug users, individuals with HIV, and hemophiliacs)

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However, the latter are unlikely to affect interpretation of the main conclusions, as administration of metformin by the enteral route has been shown to be more effective for glucose-lowering than intravenous or intraportal administration [5], and pharmacological inhibition of renal excretion of metformin, thereby augmenting plasma metformin concentrations, has little impact on blood glucose [41]

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