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At the tissue level, in vitro work using isolated pancreatic islets has characterised tirzepatide's effect on glucose-stimulated insulin secretion (GSIS), with multiple groups reporting that the dual-agonist produces greater cAMP accumulation in -cells than mono-agonists at matched concentrations

Kraus et al., Nature Medicine show that NNMT inhibition can increase energy expenditure and improve metabolic health without altering diet or activity

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