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To avoid enzymatic cleavage by DPP-4, the N-terminal penultimate amino acid has been replaced with other amino acids (albiglutide, dulaglutide, and semaglutide) or added with a fatty acid moiety (liraglutide and semaglutide), so that albumin binds and shields the enzymatic attack site
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They are also generally avoided in patients with Multiple Endocrine Neoplasia syndrome type 2
Understanding any potential interactions can help ensure both medications work effectively
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