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The most recent understanding of this deficit suggests that it relates to deterioration of the GLP-1 effect, with impaired capacity to secrete insulin, increasing insulin resistance, and hyperglycemia, perhaps leading to a decrease in GLP-1 receptor expression and resulting in GLP-1 resistance (7)

10.2 Mechanism of action of different drugs for the treatment of type 2 diabetes 10.2 From the Classical Approach to the New Drugs in the Treatment of Type 2 Diabetes 10.2.1 Metformin According to national and international guidelines, metformin is the recommended first-line oral therapy for the treatment of type 2 diabetes together with lifestyle intervention at the time of diagnosis

The antibodies used are listed in Table 1

doi:10.1056/NEJMoa2416394