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Native IGF-1 produced by the liver in response to growth hormone binds immediately to six different IGF-binding proteins (IGFBP-1 through IGFBP-6), which reduces free circulating IGF-1 to less than 1% of total serum levels
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For example, in tubular epithelial cells exposed to high glucose, Exendin-4 reduced TGF--induced fibronectin and COL1A1 expression and decreased secretion of the microRNA miR192, which is implicated in kidney fibrosis, pro-fibrotic microRNA-192, a mediator implicated in renal fibrosis [59]
Remove and gently pat the remaining essence into the skin
It occurs more commonly with higher doses or when injecting on an empty stomach
![Cardiovascular disease continuum-GLP-1 action. Adapted from [46]](https://www.researchgate.net/publication/357072789/figure/fig1/AS:1146405179654167@1650335702879/Cardiovascular-disease-continuum-GLP-1-action-Adapted-from-46.png)
