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doi:10.1016/j.diabres.2021.108904 25

SGLT2 , sodium-glucose cotransporter 2

When a GLP-1 agonist binds its receptor, it can activate two downstream pathways: cAMP (G-protein) pathway: Mediates the metabolic benefits (insulin secretion, appetite suppression, glucose control) Beta-arrestin pathway: Triggers receptor internalization and desensitization, and may contribute to nausea and vomiting Drugs that preferentially activate the cAMP pathway while minimizing beta-arrestin recruitment -- called "biased agonists" -- may maintain efficacy while reducing GI side effects

Gently swirl the vial to mix the solution