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As a dual agonist, it activates two separate hormone receptors in your body: GLP-1 and GIP

The improvement in the TyG index and to a lesser extend the HOMA-IR is to be expected as the FPG levels improved significantly following linagliptin intervention in the high GLP-1 group of both the prediabetes and T2D populations despite the non-significant drop in the fasting insulin levels

However Lillys demonstration that a GIP/GLP-1 receptor co-agonist (tirzepatide) has superior efficacy compared to selective GLP-1 receptor agonists, has renewed interest in the first incretin. Lilly rolled out their SURPASS trials to position their agent amongst existing diabetes medications and GLP-1 agonists

In this context, the rise in glucose may indicate reduced cellular utilization, potentially secondary to insulin resistance or mitochondrial inefficiency