Short acting agents (such as exenetide) exert their effect mostly by slowing gastric emptying, which reduces post-prandial glucose levels
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Glucoraphanin is hydrolyzed by myrosinase, releasing glucose and a hydrogen sulfate ion and forming sulforaphane
For the newer GLP-1 medications, it would be useful to look at whether there are genetic variants, like the variants in PAM, that explain poor responders to their medications. For now, the mechanism driving GLP-1 resistance remains unresolved, but it is likely complex and multifactorial, Gloyn said