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At the level of post-translational modification, the sirtuin SIRT4 ADP-ribosylates and downregulates GDH in beta-pancreatic cells, thereby decreasing insulin secretion in response to amino acids during calorie-sufficient conditions [74]

This cycle repeats until their capacity is also severely diminished

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In terms of which medication is more effective for the treatment of type 2 diabetes, this would depend on your symptoms and how much management they need

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