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( Reference Kanoski, Fortin and Arnold 137 ) shows that the suppressive effects of long-lasting GLP-1 agonists are not exclusively mediated by a peripheral action, but also require some central activation, while others have shown that blood-borne GLP-1 does not require peripheral participation ( Reference Ruttimann, Arnold and Hillebrand 138 , Reference Zhang and Ritter 139 )
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In this narrative review, we summarize the mechanisms, clinical efficacy, safety, comparative positioning, and evidence gaps relevant to long-term real-world evaluation and next-generation incretin-based therapies
