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The glucagon-like peptide 1 receptor agonist exenatide inhibits small intestinal motility, flow, transit, and absorption of glucose in healthy subjects and patients with type 2 diabetes: a randomized controlled trial

GLP-1 Receptor Activation Metabolic Regulation GLP2 activates GLP-1 receptors with lower potency than endogenous GLP-1 but demonstrates biased signaling properties: Preferential cAMP pathway activation over beta-arrestin recruitment, which may enhance insulin secretory responses Suppression of inappropriately elevated glucagon secretion during hyperglycemia Reduced GLP-1 receptor internalization compared to native GLP-1, potentially extending signaling duration Contribution to glucose-dependent insulin secretion complementary to GIP receptor effects Research in isolated pancreatic islets demonstrated that GLP2s insulinotropic actions depend on GIP receptor presence, with the biased GLP-1 receptor signaling providing synergistic enhancement

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These stimuli are transmitted to the brain, inducing satiety and activating secretory cells in the intestine to release appetite-suppressing hormones, such as PYY and serotonin, which stimulate the hypothalamus to create a feeling of fullness (22)

Kahn also calls the peptide category a bit of a gray zone, given its uncertain regulatory status, but says she wants to emphasize that patients cannot simply buy peptides from compounding pharmacies