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Furthermore, concentrations of up to 300 mM glucose do not induce GLP-1 secretion from colonic human mucosa because GLP-1 producing L-cells barely express SGLT1 ( Consistently, the use of -methyl-D-glucopyranoside (MDG), an acaloric substrate of SGLT1, within 5 min triggers the release of GLP-1 as glucose does, demonstrating how it is the sodium current that triggers the release of the incretin, and not the metabolic ATP-driven arrest of potassium currents and following calcium spike ( The pharmacological blockage of SGLT-1 with phloridzin, in a rat small intestine perfused system, results in just a halved secretion of GIP, GLP-1, or PYY, and the addition of phloretin, a GLUT2 inhibitor, brings these values down to basal levels

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PLoS One 12 , e0176446 (2017)

Both semaglutide and tirzepatide are available in compounded form, and the enrollment process follows the standard telehealth model of questionnaire, provider review, and direct-to-patient shipping