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Of note, the mean basal insulin dose at the study endpoint (week 52) was 48.8 U with insulin degludec in the SURPASS-3 trial and 43.5 U with insulin glargine in the SURPASS-4 trial [20, 21]
Three consecutive prolines at positions 35 (Pro-Pro-Pro) and an additional proline at position 8 create local conformational rigidity through the unique angle constraints of pyrrolidine-containing residues
Additional challenges arise from drug R&D innovations, such as carryover, extraction recovery, and sensitivity issues
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