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Efficacy and safety of once-weekly semaglutide versus once-daily insulin glargine as add-on to metformin (with or without sulfonylureas) in insulin-naive patients with type 2 diabetes (SUSTAIN 4): A randomised, open-label, parallel-group, multicentre, multinational, phase 3a trial
This framework highlights that long-term metabolic stability during GLP-1RA therapy depends not only on energy balance but also on maintaining proportionality between oxidative throughput and substrate-supported regenerative capacity
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