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We propose that GLP-1 analogs are superior to DPP-4 inhibitors for managing pasireotide-induced hyperglycemia because GLP-1 analogs, unlike DPP-4 inhibitors, spare pasireotide-induced depletion of endogenous GLP-1 and restore insulin secretion suppressed by pasireotide through GLP-1R-Gs activation, counteracting the SSTRs-Gi axis