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Comparative Mechanisms with Other Agents Compared with metformin, which improves insulin sensitivity primarily through hepatic and muscular pathways, GLP-1 RAs act centrally and peripherally to influence appetite, glucose metabolism, and systemic inflammation

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Fmoc deprotection was achieved with 20% piperidine in DMF (twice for 2 min, room temperature, 300 rpm shaking) and peptide couplings were performed as double or triple couplings (twice for 5 min, 75 C, 300 rpm shaking, except for Arg and His, for which twice for 5 min, 50 C, 300 rpm shaking) consisting of AA/HCTU/DIPEA (ratio, 1:1.25:2.5) in fivefold excess compared to the resin