Poor Sleep Quality : Many individuals experience disruptions in sleep, leading to less effective rest and recovery
Thousands of patients have received GLP-1 receptor agonists in randomized controlled studies lasting months to years
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5, 7 As such, they remain in circulation long enough to cross the bloodbrain barrier
Cost, side effect tolerance, and cardiovascular/renal protection goals also influence the decision
Packer recently proposed an intriguing hypothesis that DPP-4 inhibitors potentiate some endogenous peptides, such as stromal cell-derived factor-1, in addition to activation of GLP-1, and that unfavorable effects of those peptides on CV parameters (e.g., inflammation, fibrosis, plaque growth, and sympathetic activation) could prevail against the CV protective effects of GLP-1, possibly leading to worsened CV complications and HF [36, 37]
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