Postprandial hyperinsulinaemia Less suppression of insulin secretion in the presence of hypoglycaemia and greater sensitivity of cells to increased blood glucose levels have been described after GBP7, mediated both by intestinal hormonal factors (increase in GLP-1 secretion)8,9 and by non-hormonal factors68 (postprandial elevation of unconjugated bile acids)7, which will be accompanied by an earlier and more intense peak of postprandial insulinaemia.7,8 One of the first hypotheses proposed was the increase in the mass of pancreatic cells with nesidioblastosis, as a result of the exaggerated secretion of GLP-110
doi: 10.1056/NEJMoa2206038
Clinical Bottom Line Taken collectively, these positions endorse a risk-adapted paradigm that balances safety with feasibility, minimizing unnecessary cancellations while preserving the substantial metabolic benefits conferred by GLP-1 RA therapy
You will need separate syringes for reconstitution and injection, or you can use a larger syringe for mixing and transfer to an insulin syringe for administration
Manufacturers should also take the reins and spearhead industry-wide conversations on the long-term economic and clinical benefits of obesity treatment
