3 However, the latest American Diabetes Association and Kidney Disease: Improving Global Outcomes guidelines now recommend glucagon-like peptide-1 (GLP-1) receptor agonists, with or without metformin, as initial pharmacotherapy for patients with type 2 diabetes who are at high risk for cardiovascular disease, heart failure, or CKD
This initiates a cascade that leads to the activation of protein kinase A (PKA), closing of potassium channels, depolarization, and release of calcium from the endoplasmic reticulum.3 An increase of intracellular calcium levels within the cell initiates insulin expression in the nucleus, stimulates energy (ATP) production in the mitochondria, and triggers the release of insulin into the blood stream in a glucose dependent manner (image adapted from Adipogen Life Sciences).4,5 Several commercially and prescribed agents are now available for the management of obesity and type 2 diabetes
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This decrease in food consumption can result in insufficient energy, contributing to feelings of fatigue
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