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Stenzel's book, Healing the Hidden Nerves , explains the cellular fallout

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The amino acid sequence and specific modifications in its chemical structure determine its ability to selectively stimulate the release of growth hormone, while avoiding some adverse reactions that traditional drugs may cause, such as increased appetite, elevated prolactin, and elevated cortisol

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Thus, high GE (HGE) and high GI (HGI) neurons increase or decrease their frequency of potential actions, respectively, in response to increases in interstitial glucose from 5 to 20 mM, although these neurons are still not thoroughly characterized, and there are doubts about their physiological significance