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The primary mechanisms of action include: Enhancing glucose-dependent insulin secretion from pancreatic beta cells, which helps lower blood glucose levels when they are elevated Suppressing glucagon release from pancreatic alpha cells, reducing hepatic glucose production [1] [2] Slowing gastric emptying , which moderates the rate at which nutrients enter the bloodstream Promoting satiety through central nervous system pathways, leading to reduced caloric intake [1] [2] These medications are peptide-based (and one fusion protein) and are temperature sensitive

This dose should be maintained for at least four weeks to assess tolerance and initial therapeutic response before considering further dose escalation

But high blood levels of B12 do not mean symptoms are well treated