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The incretins are a group of gastrointestinal hormones that cause an increase in the amount of insulin released from the beta cell islets of Langerhans after eating, even before blood glucose levels become elevated

[7] [8] This pathway is influenced by the gut microbiome, as intestinal bacteria modify bile acid composition

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Ipamorelin, developed by Novo Nordisk in the late 1990s, represents the third generation by incorporating non-natural amino acids (alpha-aminoisobutyric acid and D-2-naphthylalanine) into a minimized pentapeptide scaffold that was specifically optimized for GHS-R1a selectivity using structure-activity relationship studies