As GEP44 acts directly on muscle tissue, while its effects on islets require concomitant Y1-R antagonism, activation of Y1-R expressed in muscle tissue may ultimately prove to be a critical factor in reducing serum glucose levels, alongside any potential effects on insulin secretion and glucagon release
However, excessive or intense exercise may worsen gut permeability, so balance is essential
However, the dominant side effects (nausea, diarrhea) come from the GLP-1 component, similar to other medications
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