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Although the currently approved treatments with GLP-1R agonists demonstrate remarkable antidiabetic effects, further improvements in this class are expected such as long-term glucose control 29

In conclusion, we observed that serum BALP followed the skeletal growth pattern with peak level at an earlier point in CVMI stage 3 and after progression of one year, it showed descent in advanced stage 3

The combination of pathways distinguishes tirzepatide's pharmacological profile and explains why clinical responses often diverge between the two medications