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Inhibiting the enzyme therefore has consequences on two fronts at once: it spares S-adenosylmethionine, and it leaves nicotinamide available to other routes, including the salvage pathway that supplies NAD

These processes can contribute to the development of ketoacidosis with relatively normal blood glucose levels, known as euDKA

Patients who prefer to continue attending appointments for their injections can do so, and anyone who chooses self-administration can return to staff-administered injections if their circumstances change. The initiative supports NHS Lanarkshires commitment to person-centred care by giving patients more choice in how they receive treatment

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