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Steps of the carnitine shuttle system Formation of Acyl-Carnitine: Long-chain fatty acids in the cytosol are activated to acyl-CoA, which then reacts with carnitine in the presence of CPT I to form acyl-carnitine

95% CI, 0.37 to 0.77) in the incidence of new onset persistent macroalbuminuria compared to placebo in the Liraglutide Effect and Action in Diabetes: Evaluation of Cardiovascular Outcome Results (LEADER) and Trial to Evaluate Cardiovascular and Other Long-term Outcomes With Semaglutide in Subjects With Type 2 Diabetes (SUSTAIN-6) trials, respectively [75,76]