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GLP-1 receptors are distributed throughout the central nervous system, including areas involved in pain processing and vascular regulation
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Direct contact between the dissolving medication and the oral and esophageal mucosa may trigger local nausea responses that subcutaneous injection avoids
While publication bias cannot be entirely excluded, a comprehensive search strategy across multiple databases was used to minimise this risk
Just that one small subtle substitution, enhancing the molecular weight by 14 daltons, substantially increased the stability of the the peptide, says Paul Levine, a chemist at peptide company Insamo in California, US
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