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The cumulative impact of impaired HPA regulation combined with compromised glucocorticoid and insulin receptor activity, aggravated by inflammatory cytokines, might explain the high rate of metabolic syndrome, diabetes, dyslipidemia, and osteoporosis in the bipolar population (88, 204)

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The field moved from single GLP-1 receptor agonism, to dual GIP/GLP-1 agonism, and then to adding a third receptor glucagon to capture an energy-expenditure lever on top of appetite and glucose control

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