glp-1 gip gcg Machine learning designs new GCGR/GLP-1R dual agonists with enhanced biological potency Possible mechanisms of glucagon‐like peptide‐1

doi: 10.3389/fendo.2021.622737 51 MorettoTMiltonDRidgeTMacconellLOkersonTWolkaAet al

Why Blood Sugar May Not Be Very High In classic DKA: Insulin deficiency severe hyperglycemia In euglycemic DKA: Some insulin is still being administered Blood glucose may appear only mildly elevated But insulin is insufficient to prevent ketogenesis This can delay recognition because: Patients and clinicians may not suspect DKA with glucose under 250 mg/dL Symptoms may initially resemble dehydration or GI illness Additional Contributing Factors GLP-1 use in Type 1 diabetes may also increase DKA risk due to: Vomiting dehydration stress hormones ketone rise Intentional insulin reduction due to fear of hypoglycemia Reduced basal insulin during weight loss Increased glycemic variability from delayed gastric emptying Hypoglycemia and the Insulin Reduction Trap Another issue is the cycle that can develop: Appetite decreases Insulin dose is reduced Hypoglycemia occurs intermittently Insulin is reduced further Ketone production increases Over time, this can push the patient into metabolic instability

smaller meals and hydration

Factors that affect your calorie needs Activity level A sedentary 70 kg woman might need 1,800 kcal to maintain her weight