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Glycemic mechanism and insulin sparing sensitization not secretion: fasting insulin and C-peptide fall while insulin sensitivity (HOMA2-%S) rises +31.8/+43.2/+49.9% (SURPASS J-mono, Hamamoto 2025)

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Studies on GLP-1 receptor agonist users show mixed results: some patients maintain normal B12 levels, while othersparticularly those with pre-existing absorption issues, vegans, or those on long-term metforminmay develop subclinical B12 deficiency

Biochemistry 5 edn, (W H Freeman, 2002)

It modulates GABAergic and glutamatergic neurotransmission, reduces somatostatin release (indirectly promoting GH secretion during sleep), modulates corticotropin (ACTH/cortisol) secretion, and influences the endogenous opioid system