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This Recommendation is based on results of three observational studies that used high-pressure (e.g., systolic blood pressure, mean arterial pressure) and/or long duration (e.g., repeated intervals of 30 minutes, 3 hours continuously)

Direct effects on cellular proliferation A genetically engineered murine model of pancreatic intraepithelial neoplasia (PanIN) to PDAC progression ( LSL-Kras G12D ;Pdx1-Cre, KC ) treated with exenatide demonstrated architectural changes of loss of polarity and micropapillary formation following 12 weeks of therapy 18

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doi: 10.1007/s10654-025-01242-9 34 WangWKouJZhangMWangTLiWWangYet al

The weight loss was augmented by the addition of GCGR-mediated increases in energy expenditure to GIPR- and GLP-1R-driven calorie intake reduction

Daily Dosing: Comparing Convenience and Compliance FDA-Approved Oral Tablets: Must be taken first thing in the morning on an empty stomach Take with only 4 ounces of water or less Wait 30 minutes before eating, drinking anything else, or taking other medications Timing and fasting window are critical for absorption Requires daily compliance Compounded ODT Formulations: Dissolve under the tongue or in the cheek Taken once daily Generally no food/water restrictions (though specific instructions vary) May be more convenient than swallowed tablets Still requires daily compliance Injectable GLP-1s: Administered once weekly at any time of day Can be taken with or without food No fasting period required More forgiving if you're slightly late with your dose Studies show that patient preferences often shift once they understand these requirements