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The FDA supports development of complex generic drugs, such as GLP-1s, by funding research and informing industry through guidance as part of our ongoing efforts to increase access to needed medications, Iilun Murphy, MD, director of the Office of Generic Drugs in the FDAs Center for Drug Evaluation and Research, said in a statement

Adjusting the protocol upfront costs nothing and matters across the 2448 week treatment window when body composition changes either compound or plateau based on whether both medications remain therapeutically effective

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These data are consistent with one of two scenarios, either (1) direct peptide-stimulated inhibition of GLP-1R and Y1-R on -cells, or (2) indirect peptide-mediated insulin release leading to inhibition of glucagon release, as observed in previous studies 50,51

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(2023) found that GLP-1 receptor agonists reduced the risk of lower limb amputation by 43% compared to sulfonylureas (HR: 0.57, 95% CI: 0.390.84), with the greatest risk reduction observed in long-term users (HR: 0.44, 95% CI: 0.270.72).(26) However, GLP-1 receptor agonists did not significantly impact diabetic foot ulcer incidence (HR: 1.08, 95% CI: 0.871.35)