Therefore, endogenous GIP seems to retain a role in postprandial glucose regulation following gastric sleeve but when the first part of the small intestine is bypassed (Roux-en-Y gastric bypass) endogenous GIP does not contribute to the postprandial glucose regulation ( 2 infusions do not affect postprandial plasma glucose levels highlighting the importance of the pancreas in GIPs glucose-regulating effects ( Infusions with GIP(3-30)NH 2 in healthy individuals during a mixed meal test or an oral glucose tolerance test as well as in persons with obesity in the fasting state do not affect glucagon levels ( 2 reduced glucagon concentrations ( Treatment with AMG133 in individuals with obesity decreases HbA1c levels and reduces fasting glucose levels in a dose-responsive manner ( 3.2 Adipose tissue In humans, infusions of GIP(3-30)NH 2 during a hyperinsulinemic and hyperglycemic clamp reduce GIP-induced blood flow to subcutaneous adipose tissue and inhibit the increase in triacylglycerol clearance observed with GIP administration ( 2 increased free fatty acid (FFA) output and a higher FFA/glycerol-ratio, suggesting a reduction in in-situ re-esterification of FFA and lipolytic activity ( Nevertheless, GIP receptor antagonism is thought to exert beneficial metabolic effects due to the expression of GIP receptors on adipocytes ( GIPR genetic variants have a lower body mass index (BMI) ( 3.3 Bone metabolism Addressing the acute changes in the postprandial state, GIP(3-30)NH 2 infusions diminished GIP-induced suppression of the bone resorption marker carboxy-terminal type 1 collagen crosslinks (CTX) in both healthy individuals ( 2 has been used to demonstrate an uncoupling of the otherwise coupled processes of bone resorption and formation assessed by a decrease in CTX and a temporary increase in the bone formation marker procollagen type 1 amino terminal propertied (P1NP) in healthy individuals ( 3.4 Appetite regulation and weight management Similar to animal studies with deletion of the GIPR gene that exhibit protection toward obesity ( GIPR gene to be associated with BMI ( GIPR variants that are pharmacologically classified as loss-of-function variants with reduced cell surface expression, cAMP production, beta arrestin 2 recruitment, internalization, and endosomal signaling have consistently been associated with lower adiposity-related traits, including BMI ( ad libitum meal test and visual analogue scale questionaries ( 3.5 Nausea Recent technological advancements have detected the GIP receptor in the brain of mice, specifically in inhibitory gamma-aminobutyric acid (GABA) neurons located within the area postrema, which function as a chemoreceptor trigger zone for vomiting ( 3.6 Memory and other cognitive functions As GIP receptor expression have been demonstrated in different brain regions of animals ( 3.7 Cardiovascular effects In a GWAS, the genetic GIP receptor variant, E354Q, and the risk of cardiovascular diseases are nominally associated ( 2 , have highlighted the crucial role of endogenous GIP in the vascular system during meal digestion

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Lienkamp K, Madkour AE, Musante A, Nelson CF, Nsslein K, Tew GN
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Yes, regular GP or specialist reviews are essential, typically within 24 weeks of starting escitalopram and monthly during Wegovy dose escalation