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A potential benefit of L-carnitine in these patients is based on the fact that it can (i) increase the oxidation of long-chain fatty acids which accumulation may contribute to insulin resistance in skeletal muscle, and (ii) enhance glucose utilization by reducing acyl-CoA concentration within the mitochondrial matrix (see Biological Activities) (42)

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That gastric stability is unusual - most peptides would be broken down rapidly by stomach acid and digestive enzymes, making oral delivery impractical