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if a meal contains no fat, the medication has no substrate to act upon

Okay, Ill give you a moment to finish your eye roll or groan, but here me out

GLP-1 and its analogues have been shown to possess direct effects on improving cardiomyocyte viability, cardiac function, and vasodilation

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These studies show the post-prandial increase in GLP-1 levels post MBS, without an increase in fasting GLP-1 levels

The assumption that it works identically is exactly that, an assumption, not a proven fact