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Proximal insulin receptor signaling and IR Insulin exerts its biological effects by binding to its cell-surface receptors, therby activating specific adapter proteins, such us the insulin receptor substrate (IRS) proteins (principally IRS1 and IRS2), Src-homology 2 (SH2) and protein-tyrosine phosphatase 1B (PTP1B), eventually promoting downstream insulin signaling involving glucose homeostasis

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Discuss reliable contraception methods with your doctor, as topiramate may reduce the effectiveness of hormonal contraceptives at higher doses

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