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As per NICE guideline NG28, if you've achieved your target HbA1c and maintained it for an extended period alongside substantial lifestyle changes, your doctor may consider whether dose reduction or medication adjustment is appropriate

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Future translational research should aim to define the carnitine-responsive phenotype using integrated approaches, including serum acylcarnitine profiling, quantitative MRI of muscle fat, and CPT1A genotyping to enable precise patient stratification