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Evidence Strength Rating Moderate plausibility via reduced intake Limited direct clinical outcome data 4.2 Vitamin B12 Physiological Role Vitamin B12 supports: Neurological function Red blood cell production DNA synthesis It is primarily obtained from: Meat Dairy Fish Why GLP-1 Therapy May Influence B12 Possible mechanisms: Reduced intake of animal products Chronic low-calorie intake Gastric acid modulation secondary to delayed gastric emptying (theoretical) Unlike metformin, GLP-1 drugs are not known to directly impair B12 absorption

However, all these treatments are symptomatic and cannot prevent or reverse AD pathology ( Figure 1 ) ( Figure 1 Biological characteristics of GLP-1 In the 1980s, a new glucagon-like peptide, produced from proglucagon cleavage, was discovered to stimulate insulin secretion ( GLP-1, a 36-amino acid peptide, is produced in enteroendocrine L-cells of the distal small bowel and colon ( The effect of GLP-1 depends on blood glucose levels since it can only potentiate glucose-stimulated insulin secretion from islet beta cells in the hyperglycemic state rather than in the normal blood glucose state (98101)

These higher doses can amplify both efficacy and side effects

One obvious advantage of the small molecule agonists in the replacement of peptide GLP-1 analogues is that they could be administered orally, thus avoiding the discomfort of subcutaneous injections and increasing the compliance of patients