Glutathione is synthesized in two sequential enzymatic reactions: glutamate cysteine ligase (GCL) catalyzes the first, rate-limiting step, and glutathione synthetase couples -glutamylcysteine to glycine in the last step [13]
( Lancet 2023, NCT04982575 [12] ) randomised 92 adults with type 2 diabetes on metformin, with or without an SGLT2 inhibitor, 1:1:1 to CagriSema (n=31), semaglutide (n=31), or cagrilintide (n=30), all escalated to 2.4 mg, across 17 US sites over 32 weeks
These symptoms are most common during therapy initiation and dose escalation, and they may improve over time as tachyphylaxis to the gastric-emptying effect develops in some patients
The damage is irreversible
Nevertheless, observational studies such as these cannot determine whether low levels of vitamin B12 were the cause of the weight gain or whether higher levels of vitamin B12 protected against lower levels
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