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Cellular energetics and metabolic adaptation American College of Cardiology (2016)
tirzepatide adds GIP (dual agonist) and retatrutide adds glucagon (triple agonist), with generally larger weight effects in trials but different tolerability profiles
Typically, these candidates are individuals with a higher body mass index (BMI) who have not achieved their desired results with other antidiabetic medications
It also requires understanding the treatment experience, recognizing musculoskeletal involvement when present, and ensuring timely rheumatology referral and appropriate management
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