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Efficacy and safety of dulaglutide monotherapy versus metformin in type 2 diabetes in a randomized controlled trial (AWARD-3)

GLP-1RAs also promote endothelial barrier integrity via activating protein kinase A (PKA)- and Ras-related C3 botulinum toxin substrate 1 (Rac1) [106]

None of these fully replaces the pharmacological benefit, but they can slow the rate of regain significantly

It remains in Phase 3 clinical trials globally, with FDA approval projected for late 2026 or early 2027

Arora Health is the entity with actual prescription authority in the Trimi program

The thinking: if the incretin pathway has reached maximum effect, stimulating a completely different pathway might restart progress without the gastrointestinal burden of higher tirzepatide doses