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Activation of GLP-1R results in a rapid (seconds to minutes) potentiation of insulin secretion from islet beta cells which is achieved via rapid cAMP production, which results in the activation of protein kinase A (PKA) and exchange protein directly activated by cAMP (Epac), and these two effectors modify several targets in the secretory machinery, resulting in enhanced insulin secretion 2,12

Introduction Type 2 diabetes mellitus (T2DM) is a complex, chronic disease that is characterized by insulin resistance and islet -cell dysfunction (Thorens, 2013)

Close collaboration between endocrinology and rheumatology or immunology specialists is advisable when managing patients with complex autoimmune conditions requiring metabolic intervention

Furthermore, ICV injection of Ex-4 into the 4th ventricle of rats causes a suppression of food intake (Hayes et al., 2011)

Additionally, it slows down the emptying of the stomach and reduces appetite, allowing for more effective nutrition absorption

Recent studies indicate that by 2030, almost 14% of men and 20% of women around the globe are expected to experience obesity (Federation 2022)