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Both ligands had similar cAMP potency but the exendin-4-C16 showed 2.5-fold bias towards G protein recruitment and a 60% reduction in -arrestin-2 recruitment efficacy compared to exendin-4, as well as reduced GLP-1R endocytosis and preferential targeting towards recycling pathways

Due to an induced delay in gastric emptying, it may potentially impact the absorption speed and effectiveness of concurrently administered oral medications