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* Correspondence: Karuna Rasineni, [email protected] These authors have contributed equally to this work and share first authorship Disclaimer All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers

All drugs show improvement during maintenance dosing: CT-388 nausea dropped from 83% (titration) to 54% (maintenance) Semaglutide and tirzepatide GI events are described as "transient" and occurring "primarily during dose escalation" Slower titration schedules generally reduce GI severity This is clinically relevant: patients who tolerate the first 4-8 weeks of dose escalation will likely experience manageable side effects long-term

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3 The development of GLP-1 receptor agonists has shown promising results in improving metabolic markers

Astrocytic insulin signaling couples brain glucose uptake with nutrient availability