However, disease states (e.g., obesity, Cushings syndrome, type 1 diabetes [T1D] and anorexia nervosa) and some commonly used drugs [e.g., glucocorticoids and glucagon-like peptide 1 receptor agonists (GLP-1RAs)] that impact pancreatic -cell insulin secretion can also alter the GH/IGF-I axis
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Indirect effects come from losing body fat, particularly visceral fat, which is metabolically active and drives insulin resistance, elevated triglycerides, and low HDL
John Buse, Director of the Diabetes Care Center at the University of North Carolina and a principal investigator in GLP-1 outcomes trials, has noted in published commentary that "the antioxidant milieu in type 2 diabetes is genuinely impaired, but whether exogenous supplementation corrects the underlying defect or simply raises circulating levels without tissue impact remains unresolved." [9] That distinction shapes the practical advice: correcting a documented deficiency (measured low whole-blood glutathione in a patient with poorly controlled diabetes) is a different clinical decision from empirically adding glutathione to a well-controlled patient already benefiting from dulaglutide's own oxidative-stress effects
Drug facts Your care team will check in regularly to see how youre feeling and help you track your results