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In particular, TNF exacerbates insulin resistance by inhibiting insulin receptor phosphorylation and GLUT4 translocation [62]

Several mechanisms have been hypothesized to explain how GLP-1 RAs could directly reduce hepatocyte storage of triglycerides, regardless of body weight loss (Figure 1)

The switch makes sense if semaglutide isnt providing adequate weight loss, if appetite suppression has plateaued, or if you need more aggressive metabolic intervention