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Seek emergency care immediately if palpitations occur with chest pain, severe shortness of breath, dizziness, fainting, or profuse sweating

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Second, proline substitutions at positions 25, 28, and 29 reduce the tendency to form beta-sheet structures that lead to aggregation

Less commonly associated side effects include hypoglycemia, acute pancreatitis, increased risk of gallbladder and biliary diseases, renal insufficiency or acute renal failure, retinopathy, and thrombocytopenia (low platelet count)