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The reasons for this vary, but the limited mechanism of action may be one contributing factor

Its important to understand that compounded GLP-1 medications are not FDA-approved and have not been formally studied in clinical trials

Michele Green told the Daily Mail

DPP-4 inhibition extends this half-life and increases circulating active GLP-1 by approximately 2- to 3-fold, which is sufficient to engage high-density pancreatic islet receptors and produce glucose-dependent insulin secretion and glucagon suppression
