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These effects are thought to be mediated through cAMP/PKA signaling downstream of the GLP-1R, leading to suppression of NF-B activation and reduced STAT3 transcription factor phosphorylation

For example, one study demonstrated that inhibition of P-glycoprotein-mediated transport with zosuquidar increased the linagliptin maximum plasma concentration (C max ) from 26 to 348 nmol/L in healthy Wistar rats

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What has some evidence Berberine , has demonstrated effects on blood sugar regulation through AMPK pathway activation and may modestly increase GLP-1 secretion in some studies