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These mechanisms are implicated in the neurobiology of BD, and preliminary findings suggest benefits across core psychopathological domains and common comorbidities, including depression, anxiety, mania, cognitive dysfunction, weight gain, and substance use disorders

However, many primary care clinicians hesitate to initiate basal insulin due to concerns regarding time or effort needed to educate patients, doubts about patient acceptance or ability to manage titration or injection, or patient fears of hypoglycemia

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