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First, GLP-1RA can activate the first messenger adenylate cyclase (AC) after binding to the receptor, which stimulates an increase in the secretion level of the intracellular second messenger cyclic adenosine phosphate (cAMP) and subsequently activates the intracellular secondary messenger protein kinase A (PKA) (48)

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DKD afflicts 2040% of people with T2D, and manifest as increased urinary albumin excretion, impaired GFR or a combination of both [3]

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