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Semaglutide and tirzepatide are "upstream" they act on incretin receptors to influence appetite regulation, gastric emptying, and glucose-dependent insulin secretion

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Research published in JCI Insight describes tirzepatide as an "imbalanced and biased" dual agonist, meaning it shows equal affinity for the GIP receptor compared to native GIP but approximately 5-fold weaker affinity for the GLP-1 receptor compared to native GLP-1

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