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Unlike direct growth hormone secretagogues that act on the GHSR (ghrelin receptor), tesamorelin operates through the GHRH receptor, stimulating physiological pulsatile GH release patterns

Patients may struggle to consume even minimal calories, potentially leading to dangerous nutritional deficits and metabolic complications

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A comparable concept to prediabetes remission has successfully been established in people with T2D in the DIRECT trial, where substantial weight loss led to a return to nondiabetic glucose levels in up to 85% of participants, although the risk of redeveloping T2D was high 15,16

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