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The gut microbiota plays a critical role in maintaining the mucosal intestinal barrier, and exposure to environmental toxicants can further exacerbate PD phenotype (Kanthasamy et al., 2019

[1] Failure to monitor at appropriate intervals risks either undertreating a child (leaving IGF-1 subtherapeutic and growth velocity unchanged) or overexposing a child to supraphysiologic IGF-1 (a theoretical carcinogenesis concern based on epidemiologic data linking high IGF-1 to certain malignancies)

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This provides further evidence that dual incretin activity can not only offset the hyperglycemic effects of glucagon activity, but even overcome it to yield net improvements in glycemic control comparable to a dual incretin alone