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Leu 14 For certain functions, the Met 14 of exenatide can be substituted with Leu 14 , because Met is easily oxidized and has little effect on activity.34 Asp 15 The Glu 21 of GLP-1 mutating into Ala or Gly negatively impacts activity.25,35 However, as Glu resembles Asp, using Asp 15 from GIP in tirzepatide should not influence its GLP-1 activity

Understanding the distinct evidence base, regulatory status, and safety profile of each agent and the complete absence of clinical data on their combined use is essential for patients and healthcare professionals navigating this rapidly evolving and largely unregulated landscape