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There are mainly two approaches to target the incretin system (1) via inhibiting the enzymatic action of DPP4 and thereby upregulating GLP-1 levels physiologically and (2) via increasing GLP-1 levels pharmacologically

Frequently Asked Questions Can GLP-1 agonists reverse leptin resistance

Ferroptosis, Cardiac Vulnerability, & Glutathione Dependency Beyond generalized oxidative injury, glutathione critically governs ferroptotic pathways, linking impaired redox control to cardiomyocyte loss and heightened vulnerability to ischemic and metabolic stress

it's that symptoms don't always seem severe until they have been building for a while