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Anyone researching alternatives to branded GLP-1 medications should understand that retatrutide will not be cheaper than semaglutide or tirzepatide at launch

The FDA determined the withdrawal was not for reasons of safety or effectiveness it was commercial

In this context, metformin emerges as the most pragmatic maintenance strategy

In mouse models of insulin resistance, it significantly inhibits NNMT activity in liver and muscle, reduces NAM methylation, increases intracellular NAD+, activates the SIRT1 pathway, promotes phosphorylation of insulin receptor substrate 1 (IRS1), enhances insulin signaling, improves insulin sensitivity, and increases glucose uptake and utilization