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Single comment threadYou are looking at one branch of three years of receptor threads, summarised so you do not have to read them — 31 comments in the full submission. View in context.
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c/glp1science·submitted 2 years ago by u/maintenance_mode_max

three years of receptor threads, summarised so you do not have to read them

Needs Sourcebranch of 10 comments

Thinking out loud about this: three years of receptor threads, summarised so you do not have to read them. GIP receptor biology is genuinely unsettled — there is a live argument about agonism versus antagonism at the receptor — and the clinical results are robust regardless, which is an uncomfortable and interesting…

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10 comments, started 2 years ago
u/niels_roos178 points·2 years ago

glucagon agonism sounds paradoxical until you read the energy expenditure work

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u/anya_salgado141 points·2 years ago

Cosigning on GIP. The genuinely interesting thing is that the biology is not settled and the clinical result is nonetheless robust.

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u/tomas_lundgren109 points·2 years ago

incretin effect first, then everything else in this board makes sense

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u/marisol_kravchenko45 points·2 years ago

Correction: that is glucose-dependent insulin secretion, which is why hypoglycaemia risk is low as monotherapy. Not the same claim as you made.

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u/nhs_waitlist_nUK159 points·2 years ago

Tried to build a mental model from mechanism alone and produced a confident prediction that the trial data flatly contradicted.

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u/annika_fonseca44 points·2 years ago

That conflates receptor affinity with clinical potency. They are related and they are not the same thing.

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u/maintenance_mode_maxOPmaintenance28 points·2 years ago

Does the effect persist with continued dosing or does tolerance develop?

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u/maintenance_mode_maxOPmaintenance14 points·2 years ago

The half-life explanation was the thing that made weekly dosing intuitive for me rather than arbitrary.

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u/ferran_dahlberg175 points·2 years ago

Cosigning on GIP.

This is the concept everything else on this board is downstream of.

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u/hassan_castellanos146 points·2 years ago

Small fix — it slows gastric emptying, it does not halt it, and the distinction matters for the mechanism you are proposing.

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The mechanism layer: incretin physiology, receptor distribution, gastric emptying, central appetite signalling, glucagon-receptor contribution, amylin co-agonism, and the pharmacokinetics that make weekly dosing possible. Papers get cited by journal and year or they get a [needs source] reply.

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