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The first GLP-1RAs will go off patent in the early 2020-ties and this will undoubtedly lower the price

The combined SUSTAIN, FLOW, and PIONEER trial programs have enrolled more than 15,000 patients and consistently demonstrated benefits beyond glycemic control, including reduced cardiovascular events, slower progression of kidney disease, and modest weight loss

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For example, Sitagliptin was shown to increase GLP-1 and GLP-1 receptor expression in spontaneously hypertensive rat renal arteries by Liu [130]

5 Glucose metabolism and insulin sensitivity Several mechanisms related to adrenergic stimulation may influence insulin sensitivity and glucose metabolism

The right response is to build maintenance protocols that are conservative on dose, aggressive on muscle protection, and disciplined about measurement