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Gastric Emptying Modulation Dual Pathway Effect Both components contribute to delayed gastric emptying through complementary mechanisms[5]: GLP3 delays gastric emptying primarily through GLP-1R and glucagon receptor pathways Cagrilintide slows gastric transit through amylin and calcitonin receptor activation Combined effects produce more sustained gastric delay than single agents Prolonged nutrient exposure in the small intestine enhances incretin release This dual-pathway gastric slowing mechanism may explain enhanced satiety and reduced caloric intake observed in combination studies

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For individuals with mild deficiencies or as a maintenance option after injections, oral B12 supplements or sublingual B12 formulations may be suitable alternatives