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Clinical evidence from the SURPASS trials indicates that tirzepatide typically improves rather than raises cholesterol levels, with most patients experiencing reductions in total cholesterol, LDL-C, and triglycerides

Neonatal exendin-4 treatment reduces oxidative stress and prevents hepatic insulin resistance in intrauterine growth-retarded rats

The cumulative effect: approximately 1% of the administered dose reaches systemic circulation negligible by standard pharmacokinetic standards, but sufficient for the GLP-1 receptor agonism needed for glycemic control and weight loss given the high potency of semaglutide