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Lancet Diabetes Endocrinol 2018;6:691–704 [DOI] [PubMed] [Google Scholar] 44.Wanner C, Inzucchi SE, Lachin JM, et al

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The four key mechanisms: Brain appetite centers: Reduces “food noise” — the constant mental preoccupation with food and cravings that many patients describe as their biggest challenge Gastric emptying: Slows how quickly food leaves the stomach, producing prolonged fullness after smaller meals Insulin response: Stimulates insulin release when blood sugar rises — improving glucose management without causing low blood sugar on its own Glucagon suppression: Reduces glucagon, a hormone that signals the liver to release stored sugar unnecessarily 2

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