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GLP-1 receptors are expressed both centrally (in the brain) and peripherally (in immune cells, the gut, and metabolic tissues)

Nature Reviews Nephrology

This dual mechanism delivers enhanced appetite suppression, improved insulin sensitivity, and greater fat metabolism compared to single-pathway therapies

lean muscle mass loss may also be of greater clinical significance People with cardiovascular disease or arrhythmias : The observed increase in resting heart rate with GLP-1 and glucagon receptor agonism warrants careful monitoring in those with established heart disease or rhythm disorders People with pre-existing diabetic retinopathy : Rapid improvement in HbA1c may be associated with early worsening of retinopathy