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(d) Some valproate gets conjugated to carnitine (VPA-carnitine), which may be renally excreted

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Engaging all three pathways simultaneously drives glucose-dependent insulin secretion through the two incretin arms while adding glucagon-receptor agonism implicated in energy expenditure, the pharmacological rationale that distinguishes it from single (GLP-1 (Sema)) and dual (GLP-2 (Triz)) incretin agonists