If you have been reading about incretin and want a single page that covers the useful parts, this is it: definitions, context, how it is studied, and the questions that come up repeatedly.
Updated 2025-12-15. Numbers and descriptions here follow the published literature rather than marketing material.
Clinical studies of semaglutide generally measure glycated hemoglobin, fasting plasma glucose, body weight, and composite cardiovascular endpoints. The SUSTAIN program enrolled adults with type 2 diabetes, while the STEP program focused on obesity without diabetes. Administration follows a stepwise escalation schedule designed to limit gastrointestinal effects during the first weeks. Reported outcomes include mean percentage weight change, the proportion of participants reaching defined weight-loss thresholds, and rates of nausea, vomiting, and diarrhea. Long-term data on durability after treatment stops are still limited and remain a topic of ongoing research.
Semaglutide is a synthetic peptide analog of human glucagon-like peptide-1, developed by Novo Nordisk and first approved in 2017 for type 2 diabetes. It belongs to the incretin mimetic class, a group of agents that reproduce the glucose-dependent actions of endogenous GLP-1. The molecule was engineered to resist degradation by dipeptidyl peptidase-4 and to bind serum albumin, extending its half-life from minutes to roughly one week. Approval for chronic weight management followed in 2021, based on large cardiovascular and obesity outcome trials.
GLP-1 receptors are expressed on pancreatic beta cells, in the gut, and in several brain regions. Receptor activation raises cyclic AMP, enhances glucose-dependent insulin secretion, and suppresses glucagon release when blood glucose is high. Effects on gastric emptying and on hypothalamic appetite circuits reduce energy intake. Because insulin release remains glucose-dependent, the risk of hypoglycemia is low when the drug is used alone. The precise contribution of each pathway to body weight change in humans remains an area of active investigation.
Pharmacological activity arises from agonism at the glucagon-like peptide-1 receptor, a G protein-coupled receptor expressed in the pancreas, the gastrointestinal tract, and the brainstem. Receptor activation raises intracellular cyclic adenosine monophosphate and enhances insulin release in a glucose-dependent manner, an effect that diminishes when blood glucose concentration is low. Other effects include slowed gastric emptying and hypothalamic satiety signalling. These pathways are described well. Receptor desensitisation rates across tissues, relative to the endogenous hormone, are still under investigation, and reported findings differ between laboratories.
The company that developed the compound filed it as a long-acting analogue, and it gained first approval in 2017 for type 2 diabetes. Later authorisations from several regulators extended the indication to chronic weight management, and the World Health Organization added the glucagon-like peptide-1 receptor agonist drug class to its model list of essential medicines in 2023. Production uses solid-phase peptide synthesis followed by side-chain conjugation and chromatographic purification. Supply constraints and cost differences across regions are well documented. Literature on long-term outcomes continues to grow, with many trials reporting surrogate endpoints rather than hard clinical endpoints.
| Property | Value | Notes |
|---|---|---|
| Molecular formula | C187H291N45O59 | Peptide backbone with a C18 fatty diacid side chain |
| Molecular weight | Approximately 4113 Da | Consistent with a 31-residue peptide plus linker |
| Appearance | White to off-white powder | Lyophilized solid; hygroscopic if left open |
| Solubility class | Sparingly soluble to soluble in water | Varies with pH and ionic strength |
| Typical analytical method | Reversed-phase HPLC with UV detection | Often paired with mass spectrometry for identity |
black tar heroin cannabis datura and other Solanaceae (formerly smoked to treat asthma) opium salvia divinorum tobacco possibly other plants (see the section below) Substances (also not necessarily psychoactive plants smoked within them):
=== Organisms === Polystyrene is generally considered to be non-biodegradable. However, certain organisms are able to degrade it, albeit very slowly. In 2015, researchers discovered that mealworms, the larvae form of the darkling beetle Tenebrio molitor, could digest and subsist healthily on a diet of EPS. About 100 mealworms could consume between 34 milligrams (0.52 gr) and 39 milligrams (0.60 gr) of this white foam in a day. The droppings of mealworm were found to be safe for use as soil for crops. In 2016, it was also reported that superworms (Zophobas morio) may eat expanded polystyrene (EPS). A group of high school students in Ateneo de Manila University found that compared to Tenebrio molitor larvae, Zophobas morio larvae may consume greater amounts of EPS over longer periods of time. In 2022 scientists identified several bacterial genera, including Pseudomonas, Rhodococcus and Corynebacterium, in the gut of superworms that contain encoded enzymes associated with the degradation of polystyrene and the breakdown product styrene. The bacterium Pseudomonas putida is capable of converting styrene oil into the biodegradable plastic PHA. This may someday be of use in the effective disposing of polystyrene foam. It is worthy to note the polystyrene must undergo pyrolysis to turn into styrene oil.
Since bats are mammals that can fly, they are considered to be liminal beings in various traditions. In many cultures, including in Europe, bats are associated with darkness, death, witchcraft, and malevolence. Among Native Americans such as the Creek, Cherokee and Apache, the bat is identified as a trickster. An East Nigerian tale tells that the bat developed its nocturnal habits after causing the death of his partner, the bush rat, and now hides by day to avoid arrest. More positive depictions of bats exist in some cultures. In China, bats have been associated with happiness, joy and good fortune, and symbolise the "Five Blessings": longevity, riches, health, love of virtue and a peaceful passing away. The bat is sacred in Tonga and is considered the property of the king. Mayan people associated bats with the gateway to the realm of the gods since they live in caves. In the Zapotec civilisation, the bat god presided over corn and fertility.
Hydroxyzine, sold under the brand names Atarax (as hydrochloride) and Vistaril (as pamoate) among others, is an antihistamine medication. It is used in the treatment of itchiness, anxiety, insomnia, and nausea (including that due to motion sickness). It is used either by mouth or injection into a muscle. Hydroxyzine works by blocking the effects of histamine. It is a first-generation antihistamine in the piperazine family of chemicals. Common side effects include sleepiness, headache, and dry mouth. Serious side effects may include QT prolongation. It is unclear if use during pregnancy or breastfeeding is safe. It was first made by Union Chimique Belge in 1956 and was approved for sale by Pfizer in the United States later that year. In 2023, it was the 39th most commonly prescribed medication in the United States, with more than 15 million prescriptions.
Sources: en.wikipedia.org
=== Law Society review === In December 2005, the Law Society revealed that it has set up a committee, named Review Committee on Capital Punishment, to examine capital punishment in the country. The president of the society, Senior Counsel Philip Jeyaretnam, said that the main focus of the review was on issues regarding administering the death penalty such as whether it should be mandatory. A report of the review would be submitted to the Ministry of Law. On 6 November 2006, they were invited to give its views on proposed amendments to the Penal Code to the Ministry of Home Affairs. In their report, issued on 30 March 2007, they argued against the mandatory death penalty:
=== Beginnings === Chromosomes were first observed in plant cells by Carl Nägeli in 1842. Their behavior in animal (salamander) cells was described by Walther Flemming, the discoverer of mitosis, in 1882. The name was coined by another German anatomist, von Waldeyer in 1888. The next stage took place after the development of genetics in the early 20th century, when it was appreciated that the set of chromosomes (the karyotype) was the carrier of the genes. Levitsky seems to have been the first to define the karyotype as the phenotypic appearance of the somatic chromosomes, in contrast to their genic contents. Investigation into the human karyotype took many years to settle the most basic question: how many chromosomes does a normal diploid human cell contain? In 1912, Hans von Winiwarter reported 47 chromosomes in spermatogonia and 48 in oogonia, concluding an XX/XO sex determination mechanism. Painter in 1922 was not certain whether the diploid number of humans was 46 or 48, at first favoring 46. He revised his opinion later from 46 to 48, and he correctly insisted on humans having an XX/XY system of sex-determination. Considering their techniques, these results were quite remarkable. In science books, the number of human chromosomes remained at 48 for over thirty years. New techniques were needed to correct this error. Joe Hin Tjio working in Albert Levan's lab was responsible for finding the approach:
Tametraline, a compound synthesized in 1978 by Pfizer, was shown to be a potent NE and DA re-uptake inhibitor with animal studies. Later on a surprisingly substantial enhancement of blocking activity of 5-HT uptake was achieved by adding chlorine atoms at C-3 and C-4 to the structure of tametraline, resulting in (+)-trans-(1R,4S)-N-methyl-4-phenyl-1-aminotetralin, a potent but nonselective uptake blocker. The (+)-cis-(1S,4S)-isomer, one of four compounds diastereomers, however exhibited significantly more selective and potent 5-HT uptake inhibiting activity compared to the other three diastereomers, where the 4-phenyl ring favours attachments at 5-HT uptake sites. The compound was named sertraline (figure 8). Although sertraline appears to differ structurally from the other SSRIs, it has a phenylaminotetralin in its structure, in which the diphenylpropylamine nucleus has been forced into a stiff bicyclic ring system. Sertraline is the second most potent inhibitor of 5-HT re-uptake which has two very interesting characteristics that distinguish it i.e. sertraline's (1) inhibiting effect on DAT and NET and (2) the binding to sigma-1 (σ1) receptor in CNS. The DAT and NET inhibition is controversial because of much weaker inhibition which it has, compared to SERT inhibition. Sertraline has about 60 times more potent inhibition potential on 5-HT than either NE or DA re-uptake. It is possible that only modest inhibition of DAT and NET is needed to cause an increase in energy, motivation and concentration, specially when added to other activity such as SERT inhibition.
In June 2020, the Serum Institute of India (SII) – a major manufacturer of global vaccines – reached a licensing agreement with AstraZeneca to make 1 billion doses of vaccine for low-and-middle income countries, of which half of the doses would go to India. Similar preferential homeland distribution may exist if a vaccine is manufactured in Australia.
In a previous research study, the researchers found that the representation of the "outcast" character with mental illness in a movie tends to get negative evaluations from the children. Regarding this, the study found that it could make the children stick with the significant levels of stigmatization in negatively labeling individuals with mental illness even when they grow up. Other research specifically focused on a particular film, Joker, found that the depiction of individuals with mental illness appears to be negative towards the audience. Regarding this, the researchers demonstrated the concerns that the film Joker could aggravate the self-stigma of individuals with mental illness with an emphasis on negative depictions. Another troubling effect is that stereotypical imagery, coupled with the lack of alternative viewpoints, further dissuades mentally ill people from seeking help or treatment. Due to the generally negative view of mental illnesses, regardless of whether or not it is based on truth, those who experience mental illness often feel dejected, embarrassed, or shameful about their diagnoses. These feelings may lead people with mental illnesses to distance themselves from loved ones and often avoid seeking help or treatment due to fear of rejection.
Sources: en.wikipedia.org
==== Conjugated ==== In the liver, bilirubin is conjugated with glucuronic acid by the enzyme glucuronyltransferase, first to bilirubin glucuronide and then to bilirubin diglucuronide, making it soluble in water: the conjugated version is the main form of bilirubin present in the "direct" bilirubin fraction. Much of it goes into the bile and thus out into the small intestine. Though most bile acid is reabsorbed in the terminal ileum to participate in enterohepatic circulation, conjugated bilirubin is not absorbed and instead passes into the colon. There, colonic bacteria deconjugate and metabolize the bilirubin into colorless urobilinogen, which can be oxidized to form urobilin and stercobilin. Urobilin is excreted by the kidneys to give urine its yellow color and stercobilin is excreted in the feces giving stool its characteristic brown color. A trace (~1%) of the urobilinogen is reabsorbed into the enterohepatic circulation to be re-excreted in the bile. Conjugated bilirubin's half-life is shorter than delta bilirubin.
== Mechanism of action == Chemically, naloxegol is a pegylated (polyethylene glycol-modified) derivative of α-naloxol. Specifically, the 6-α-hydroxyl group of α-naloxol is connected via an ether linkage to the free hydroxyl group of a monomethoxy-terminated n=7 oligomer of PEG, shown extending at the lower left of the molecule image at right. The "n=7" defines the number of two-carbon ethylenes, and so the chain length, of the attached PEG chain, and the "monomethoxy" indicates that the terminal hydroxyl group of the PEG is "capped" with a methyl group. The pegylation of the 6-α-hydroxyl side chain of naloxol prevents the drug from crossing the blood–brain barrier (BBB).
Teasel; fruit is an aggregation of cypselas. Tuliptree; fruit is an aggregation of samaras. Magnolia and peony; fruit is an aggregation of follicles. American sweet gum; fruit is an aggregation of capsules. Sycamore; fruit is an aggregation of achenes. The pistils of the raspberry are called drupelets because each pistil is like a small drupe attached to the receptacle. In some bramble fruits, such as blackberry, the receptacle, an accessory part, elongates and then develops as part of the fruit, making the blackberry an aggregate-accessory fruit. The strawberry is an aggregate-accessory fruit, with its seeds in achenes.
=== Main === Ms. Pat as Patricia "Pat" Ford Carson, the matriarch of the Carson household. She, like Ms. Pat in real life, grew up in rough conditions in Atlanta, had two children when she was a teenager, and moved to Plainfield with her husband with whom she has two more children. While her older kids' father abused her and provided her with little to no support, her husband Terry loves her and acts as the loving partner she never had with her older kids' father. Patricia has four children: Ashley and Brandon, from her first relationship with Lloyd; and Janelle and Junebug, from her marriage to Terry. J. Bernard Calloway as Terry Carson, Patricia's well-meaning husband. He is based on Ms. Pat's husband, Garrett. Though his wife grew up with a lack of a strong support system, he provides her with the real love and stability that she never had during her turbulent childhood. Tami Roman as Denise Ford, Patricia's free-loading sister who lives with the family. Often a source of comedic tension between Ms. Pat and Terry, she struggles to keep a job. Vince Swann as Brandon James, Patricia's sweet, but dimwitted son from a previous relationship with Patricia's ex-boyfriend from Atlanta. He is based on Ms. Pat's son, Nikia. Briyana Guadalupe as Janelle Carson, Terry and Patricia's sour and intellectual daughter who is almost 17 years old. She is based on Ms. Pat's daughter, Garrianna. Theodore John Barnes as Junebug Carson, Terry and Patricia's cheerful youngest child, who is 14 years old and obsessed with social media. He is based on Ms. Pat's son Garrett "Junebug," Jr.
Sources: en.wikipedia.org
It is given either as a once-weekly subcutaneous injection or as an oral tablet taken once daily. The two forms use different absorption strategies, so they are not interchangeable on a milligram-for-milligram basis.
Structural modifications, including a fatty acid side chain and non-natural amino acid substitutions, slow enzymatic breakdown and promote albumin binding. These changes support once-weekly dosing rather than twice-daily administration.
The pathways involving insulin, glucagon, gastric emptying, and appetite signaling are well described. How much each pathway contributes to weight reduction in a given person is not fully established.
It is a glucagon-like peptide-1 receptor agonist, often grouped with the incretin mimetics. Its backbone is modified from the human hormone to resist enzymatic degradation and to bind albumin. These two features distinguish it from the native peptide.