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Southern Medical Association

With respect to the primary endpoint of A1C reduction from baseline, dulaglutide 4.5 mg was superior to the 1.5 mg dose at Week 36 under the treatment regimen estimand (mean change from baseline [mean baseline 8.6%]: dulaglutide 1.5 mg -1.54%, dulaglutide 4.5 mg -1.77%

Reviews suggest that improvements in other conditions, like blood pressure and knee pain, are mostly linked to weight loss rather than a strong direct drug effect

Secondly, GLP-1RAs attenuate apoptosis induced by TNF- by ameliorating mitochondrial dysfunction related to activating the GLP-1R/cAMP/PKA and AMPK/SIRT1 pathway [94, 157, 158]

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Microdosing may help tackle all these problems as it involves smaller doses that bring subtle and sustainable results instead of rapid changes