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It was proposed that since icodec has a longer fatty diacid side chain compared to semaglutide (20-carbon versus 18-carbon long fatty diacid, respectively), icodec would have a relatively higher affinity for albumin and thus could outcompete semaglutide for the fatty acid binding sites on albumin

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This variation reflects differences in baseline metabolism, activity level, medication adherence, and genetic factors affecting peptide pathway sensitivity