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Native GLP-1 has a short half-life and is degraded in minutes by dipeptidyl-peptidase 4 (DPP-4), mediated by alanine at position 8 [16]

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When HbA1c is considered unreliable, UK and WHO guidance recommends using fasting plasma glucose or a 75 g oral glucose tolerance test (OGTT) for diabetes diagnosis or assessment, as outlined in WHO 2011 guidance on the use of HbA1c in diabetes diagnosis and reflected in NICE NG28 (Type 2 Diabetes in Adults: Management)

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Some providers combine sermorelin with ipamorelin or other peptides