Because IGF-I exerts anti-inflammatory actions and is important for peripheral glucose uptake, metabolic disturbances in these patients can, in part, be explained by the low IGF-I levels (83)
Specifically, we observed an upregulation of Glp1r (encoding glucagon-like peptide-1 receptor, GLP-1R), Htr4 (encoding 5-HT4 receptor), and Ntsr1 (encoding neurotensin receptor 1, NTR1)
Twelve discontinued dulaglutide without any replacement, 27 switched to dipeptidyl peptidase-4 inhibitors (DPP4i), 26 to sodium glucose cotransporter-2 inhibitors (SGLT2i), and three to a combination of both (Table 1)
Importantly, preclinical studies showed that weight reduction occurred particularly in abdominal adipose tissue, the visceral fat depot most strongly associated with metabolic health risks