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It lowers the activity ofKEAP1, increases NRF2, and promotes the production of protective enzymes

24 Secondly, activated Akt phosphorylates forkhead box O1 (FOXO1), a transcription factor upregulating gluconeogenesis rate-limiting enzyme such as phosphoenolpyruvate carboxykinase (PEPCK) and glucose-6-phosphatase (G6Pase), and translocate it from nucleus to cytoplasm, which inactivate its transcriptional activity, thus inhibiting gluconeogenesis

A handful of peptides have completed the full FDA approval process for a specific use

194 It is important to note that while PPI therapy and twice-daily dosing for extra-digestive GERD are not officially approved indications, they are nonetheless recommended by both gastroenterology 195,196 and other specialty guidelines

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