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CD44 Two human genetic studies have suggested that polymorphisms in the CD44 gene may account for variations in toxicity following paracetamol overdose [39, 42]

Prof Ralph DeFronzo) advocated dual and triple therapy: start patients on low doses of one or two complementary pleiotropic agents and titrate over time and on the basis of increasing HbA1c

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By addressing this metabolic mechanism, patients can often maintain results on lower doses and avoid dose escalation