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Clinical evidence supports its use across the spectrum of disease severity, from newly diagnosed patients to those with longstanding diabetes inadequately controlled on multiple oral agents or basal insulin

Since RNF4 is a small protein with a predicted very long unstructured N-terminal region and only a small structured domain at the C-terminus, it is challenging to develop ligands targeting selectively RNF4 34

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Understanding these variants does not predict exact medication response, but reveals inherited tendencies that can support more targeted provider conversations about semaglutide, tirzepatide, or dual-compound protocols