For people over 50, this contributes directly to the classic post-meal energy crash, creeping weight gain around the midsection, and the gradual loss of muscle mass associated with sarcopenia
Ahrn B (2019) DPP-4 inhibition and the path to clinical proof
& Schiff, I
This notion is in stark contrast to the well-known anti-diabetic properties of BAs sequestrants, (343) and some, have proven to elicit GLP-1 secretion via TGR5 mediated PC1/3 upregulation (344)
Bottom line Oral semaglutide works best when you take it the right way in the morning on an empty stomach, at least 30 minutes before having any food, drinks, or other medications
35 Notably, this protective effect appears to be dependent on the duration of treatment, with only a GLP-1RA treatment period exceeding 52 weeks being associated with decreased fracture risk