PMCID: PMC6093191
were the first to describe increased whole gut permeability in patients with alcohol abuse without significant liver disease, measured by a 24 h urinary excretion of 51 Cr-EDTA, which was confirmed by increased uptake of macromolecules (inulin, EDTA and cyanocobalamin) ex vivo in jejunal biopsies (145)

Abbreviations ABCG2: ATP-binding cassette transporter G2 Akt: Protein kinase B AMPK: AMP-activated protein kinase BMP4: Bone morphogenetic protein 4 cAMP: Cyclic adenosine monophosphate cas-3: Caspase-3 CDK2: Cyclin-dependent kinase 2 c-Myc: Myelocytomatosis oncogene CRC: Colorectal cancer CREB: CAMP-response element binding protein DPP-4: Dipeptidyl peptidase IV E-cad: E-cadherin ECM: Extracellular matrix EGFR: Epidermal growth factor receptor ENZ: Enzalutamide EMT: Epithelial-mesenchymal transition ERK: Extracellular signal-regulated kinase Ex-4: Exendin-4 FGFR: Fibroblast growth factor receptor GIP: Glucose-dependent Insulinotropic Polypeptide GLP-1: Glucagon-like peptide-1 GLP-1RAs: Glucagon-like peptide-1 receptor agonists GPCR: G-protein-coupled receptor GSK3: Glycogen Synthase Kinase 3 HPV-16E7: Human papillomavirus type 16 E7 protein ICAM-1: Intercellular adhesion molecule-1 IGF: Insulin-like growth factor IL: Interleukin LC3I/II: Microtubule-associated proteins light chain 3I/II LNG-IUD: Levonorgestrel-releasing intrauterine device MAPK: Mitogen-activated protein kinases MMP: Matrix metalloproteinase mTOR: Mammalian target of rapamycin NAFLD: Non-alcoholic fatty liver disease NASH: Non-alcoholic steatohepatitis NETs: Neutrophil extracellular traps NF-B: Nuclear factor kappa B PGR: Progesterone receptor PI3K: Phosphatidylinositol-4,5-bisphosphate 3-kinase PKA: Protein kinase A PSC: Pancreatic stellate cell RCTs: Randomized controlled trials RhoA: Rho-associated kinase ROS: Reactive oxygen species S6K1: Ribosomal s6 kinase 1 SDF-1: Stromal cell-derived factor-1 SGLT2: Sodium-dependent glucose transporters 2 SKP2: S-phase kinase-associated protein-2 STAT3: Signal transducer and activator of transcription 3 T2DM: Type 2 diabetes mellitus TGF-: Transforming growth factor-beta TIMP: Tissue inhibitor of metalloproteinase TNF-: Tumor necrosis factor-alpha TZD: Thiazolidinediones VCAM-1: Vascular cell adhesion molecule-1 VEGF: Vascular endothelial growth factor References Feier CVI, Vonica RC, Faur AM, Streinu DR, Muntean C

But it does mean you're accepting risks that don't exist with topical application, for benefits that may not be meaningfully greater
As always, check with your doctor if you're managing a medical condition or taking medications that affect blood sugar or digestion
In any case, patients should not decide by themselves to start a GLP-1 pill a doctor review is critical to ensure the treatment is safe and appropriate for the individual