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The extracellular HMGB1 acts as a DAMP molecule which produces several redox forms that bind with multiple receptor types thereby inducing a cascade of inflammatory responses, particularly in diabetes

starvation is a known trigger for euglycemic ketoacidosis 36,37

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On the other hand, while the triagonist, GLP1/GIP/Glucagon, was very effective in terms of body weight lowering, in keeping with previous references 42 , treatment of PWA mice led to a massive, likely detrimental weight loss, also at the expense of lean mass, that was not bound to clear amelioration of glucose intolerance in androgenized female mice

Apolzan JW, Venditti EM, Edelstein SL, et al

The ADA/EASD consensus on glycaemic management algorithm already includes GLP-1 receptor agonists with cardiovascular benefit as an option for people with CKD when SGLT2 inhibitors are contraindicated or not tolerated, in order to reduce the risk of cardiovascular disease (Davies et al, 2022)