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The substitution (Y10 P in tirzepatide) and modification (lipidated K10 P in peptide 20) stabilized the binding of dual and triple agonists by newly-formed interactions with residues surrounding the TM1-TM2 cleft, a phenomenon unseen in the case of GLP-1 23
Patients who choose platforms with no structured monitoring cadence should arrange follow-up labs proactively, ideally at the 3-month mark after initiation and every 6 months thereafter
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