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Unlike semaglutide, which targets only GLP-1 receptors, tirzepatide is a dual agonist it activates both GLP-1 and GIP (glucose-dependent insulinotropic polypeptide) receptors simultaneously

Whether glucagon counter-regulation to hypoglycemia is affected during DPP-4 inhibition in type 2 diabetes has been studied in drug-nave subjects (138), in subjects when a DPP-4 inhibition was added on to insulin therapy (139), and in elderly subjects with metformin-treated type 2 diabetes (140)

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