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The Vildagliptin in Ventricular Dysfunction Diabetes (VIVIDD) trial (194) was conducted in patients with type 2 diabetes and functional heart failure (Class I-III, New York Heart Association)

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In diabetic patients with ketosis, acetylcarnitine represented 61% of the total urine acylcarnitines, and decreased dramatically upon insulin treatment [8]

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Some people even alternate between both, which can be particularly frustrating