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Initially, fatty monoacids were used to mimic the transport of endogenous fatty acids, followed by the introduction of fatty diacids, which provide enhanced affinity for albumin and subsequently longer half-lives due to the presence of an additional carboxylic group at the end of the alkyl chain

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Each of these levels represented a possible long-term dose for evaluation, and investigators carefully tracked weight reduction, HbA1c changes, lipid shifts, and tolerability at each step