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2) those with cyclical vomiting and lethargy, episodic extreme irritability, ataxia, low BUN, or protein avoidance

The choice depends on the individual's diabetes control, previous treatment response, and specific clinical circumstances

Biochim Biophys Acta 1830:31123120 Yasin M, El-Mehdawi AF, Anwar A, Pilon-Smits EA, Faisal M (2015) Microbial-enhanced selenium and iron biofortification of wheat ( Triticum aestivum L.)applications in phytoremediation and biofortification

The primary mechanisms of action include: Enhancing glucose-dependent insulin secretion from pancreatic beta cells, which helps lower blood glucose levels when they are elevated Suppressing glucagon release from pancreatic alpha cells, reducing hepatic glucose production [1] [2] Slowing gastric emptying , which moderates the rate at which nutrients enter the bloodstream Promoting satiety through central nervous system pathways, leading to reduced caloric intake [1] [2] These medications are peptide-based (and one fusion protein) and are temperature sensitive

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