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A 45-year-old man with a 16-year history of type 1 diabetes presents with postprandial fullness that is associated with vomiting and bloating. He has proliferative retinopathy and moderate autonomic neuropathy that manifests as postural hypotension and impotence. A 4-hour scintiscan of a radiolabeled meal shows the pattern presented in the following figure. What enteroendocrine peptide has gastric actions and may worsen this patient's symptoms?

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