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It has even been indicated that all GLP-1 released by L-cells is inactivated before it reaches the pancreas and that GLP-1 mediated insulin release is induced by local paracrine actions in the islets during the postprandial period, and there is emerging evidence that this is the case, which would mean that GLP-1 released by L-cells only acts on its receptor (GLP-1R) expressed on nerve terminals of neighboring vagal afferents, conveying signalling to the solitary nucleus of the hindbrain to promote satiety, delay gastric emptying and suppress hepatic glucose production

This means that compounded semaglutide products are no longer permitted under current regulations

Mounjaro at 15mg activates both GLP-1 and GIP receptors simultaneously

Malempati S, Weigel B, Ingle AM, Ahern CH, Carroll JM, Roberts CT, et al