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Small observational studies and posthoc analyses of trials primarily designed for metabolic endpoints have hinted at mood improvements

However, these trials specifically excluded patients with previous bariatric surgery, creating an evidence gap regarding efficacy and safety in this population

While insulins and GLP-1RAs have been considered equally effective at reducing HbA 1c [41, 42], a more recent meta-analysis reported that long-acting, once-weekly GLP-1RAs (exenatide and dulaglutide) achieve significantly greater reductions in HbA 1c than basal insulins such as insulin detemir, insulin glargine and insulin degludec [43]

It reduces appetite, slows gastric emptying, and supports insulin response