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It was marketed as Byetta (produced by Eli Lilly & Amylin Pharmaceuticals)
Unlike most vitamins, B12 has a uniquely complex absorption pathway: Stomach acid and pepsin release B12 from food proteins B12 binds to R-proteins (haptocorrins) in saliva and stomach Pancreatic enzymes release B12 from R-proteins in the small intestine B12 binds to intrinsic factor (produced by gastric parietal cells) The B12-intrinsic factor complex is absorbed in the terminal ileum A breakdown at any of these five steps causes deficiency which is why B12 deficiency is far more common than dietary intake alone would predict
GLP-1 agonists are known to enhance insulin secretion, suppress glucagon release, slow gastric emptying, and promote satiety
Importantly, in patients with CKD, who have a higher baseline risk of cardiovascular and renal events, the benefits on cardiovascular and renal outcomes are not diminished even as kidney function declines [26]
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