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Over time, pharmacological engineering enabled: Short-acting injectables (e.g., exenatide) Long-acting once-weekly injectables (liraglutide, semaglutide) Multi-target incretin therapies (tirzepatide) Oral peptide formulations and now oral small molecules The most recent breakthrough is the development of orally available GLP-1 receptor agonists, including: Orforglipron (Lilly) Elecoglipron (AstraZeneca) These compounds eliminate the need for injection and could dramatically expand accessibility and adherence in obesity and diabetes populations

You will need frequent medical tests

Metformin decreases liver uptake of lactate increasing lactate blood levels which may increase the risk of lactic acidosis, especially in patients at risk