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Glucagon plays a role in energy metabolism and fat oxidation, which may explain the more substantial weight loss observed in early research
Additionally, GLP-1 has been shown to enhance the proliferation and differentiation of endothelial progenitor cells through upregulation of VEGF, potentially promoting angiogenesis that could contribute to retinal complications [101,102]
Accordingly, the American Diabetes Association recommends the use of GLP-1RAs with or without metformin in patients with atherosclerotic cardiovascular disease (ASCVD), chronic kidney disease (CKD), and/or heart failure (HF) [25]
When GLP-1 medications are contraindicated Some patients cannot tolerate GLP-1 medications due to severe gastrointestinal side effects, a personal or family history of medullary thyroid carcinoma, or active gallbladder disease
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