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In a cohort study of 125,474 patients initiating GLP-1 RAs in the United States, 64.8% of patients without type 2 diabetes discontinued within one year (Goodwin Cartwright et al., 2025)
On the other hand, the most abundant DPP-IV-processed metabolite GLP-1 (9-36) NH2 , has also been reported to have biological activities, protecting human aortic endothelial cells and cardiomyocytes in vivo in dogs (137) and ex vivo in mice (138) and rats (139), even in the absence of a GLP-1 Receptor (140, 139)
When they later begin tirzepatide, there may be a period of overlap while tirzepatide titrates up to therapeutic levels
The standard protocol for semaglutide involves a once-weekly injection, a schedule designed to leverage the medications long half-life and maintain consistent therapeutic levels in the body
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