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He Q, Sha S, Sun L, Zhang J, Dong M (2016) GLP-1 analogue improves hepatic lipid accumulation by inducing autophagy via AMPK/mTOR pathway

[2] [6] In healthy adults, vitamin B 12 deficiency is not common, mainly because body stores of the vitamin are substantial and turnover is slow, with relatively low dietary requirements

This approach allows additional adaptation time without abandoning the therapeutic protocol

PMID: 35481829

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While glucagon does raise blood sugar, the dual incretin activity of GLP-1 and GIP offset these hyperglycemic effects while retaining the energy expenditure benefits