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Investigational or device-based incretin delivery systems (e.g., continuous subcutaneous exenatide infusion [ITCA 650]) were excluded to maintain clinical comparability with conventionally administered GLP-1RA formulations used in routine practice and represented in other major CV outcome trials

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First Principle: Proportionality A defining feature of chronic energy flux constriction is that gradual shifts in substrate availability may reduce ATP/NADH generation efficiency and redox buffering reserve without exceeding conventional diagnostic thresholds

Oral supplements can be useful for maintenance between IV sessions but are unlikely to produce the same results on their own

Reiser K, et al

Via these mechanisms, it can have the paradoxical effect of reducing the efficacy of anti-cancer agents