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Since 2021, GLP-1s have eroded metformin as the preferred first-line therapy for many patients, despite metformins lower cost and oral administration

Early trials with short-acting GLP-1 agonists showed pronounced gastric emptying delays

Recent studies using isotopic tracer techniques have quantified the relative contributions of these pathways, revealing that mitochondrial O 2 production initiates about 45% of hyperglycemia-induced damage, while PKC activation and AGE formation account for 30% and 25%, respectively (Pardina et al., 2024)

Drop one dose level every 4 weeks (for example, from 10mg to 7.5mg to 5mg to 2.5mg)

The first is delayed gastric emptying

Growing up