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Does not significantly inhibit related SAM-dependent methyltransferases or enzymes in the NAD+ salvage pathway NAD+ increase : By preventing nicotinamide methylation to 1-MNA, more nicotinamide remains available for conversion to NMN and subsequently to NAD+ via the salvage pathway

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This case is notable because the patient had previously tolerated dulaglutide without any injection site reactions, emphasizing that tolerance to one GLP-1 agonist does not predict tolerance to another