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In T2D, these effects mitigate hyperglycemia-induced lipotoxicity and advanced glycation end-products, which contribute to microvascular dysfunction and myocardial stiffness in HFpEF [29]

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Special Populations Patients with Type 2 Diabetes This group carries the highest combined risk: they are most likely to be on metformin, they may already have diabetic peripheral neuropathy (making B12-related neuropathy harder to detect), and they are the primary target population for retatrutide's glycemic indication