Personal or family history of MTC or in patients with MEN2
A 2021 study published in Nature Microbiology identified a specific protein, called P9, that is secreted by Akkermansia and was shown to directly stimulate GLP-1 release from intestinal L-cells in mice
References Paglia DE, Valentine WN: Studies on the quantitative and qualitative characterization of erythrocyte glutathione peroxidase
Given the invasive nature of the procedure, the rehabilitation involved, and the psychological strain it can entail, this surgery deserves tremendous thought
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The effect on stroke is remarkable (and was significant in the trials of both semaglutide and dulaglutide), amounting to an 18% risk reduction, also because the other class of new antidiabetic agents with cardiovascular benefits, the SGLT2-inhibitors, show no a similar effect on stroke (but do have a significant effect on heart failure) [24]
