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First, the effect is enzymatic and cumulative you are shifting a metabolic set-point over days and weeks, not triggering an acute hormonal event, which is why steady daily exposure matters more than any single large dose

Future studies should explore whether perioperative hydration protocols, electrolyte monitoring, or cardiovascular screening could help mitigate these risks while maximizing the benefits of GLP-1 agonists in orthopedic surgical populations

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