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These glucose improvements result from multiple mechanisms: enhanced insulin secretion through GLP-1 and GIP receptor activation, improved insulin sensitivity in peripheral tissues, and optimized hepatic glucose production through balanced glucagon signaling

Because the elimination half-life is approximately one week and steady-state exposure builds over 4 to 5 weeks of once-weekly administration, exposure declines slowly, which is why the labels specifically contemplate a prolonged period of observation and treatment rather than a short one

Holding duration will vary based on frequency of administration, with day of surgery for daily formulations and a week prior for weekly formulations being the current recommendation

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But does this signal the end of the road