doi: 10.1007/s00405-016-4066-6 25 WoessmannWNeugebauerMGossenRBlutters-SawatzkiRReiterA
Kisspeptin: Good safety profile in clinical trials, physiological mechanism, short-acting, but not yet approved and with less long-term data
Method Absorption Rate Advantages Disadvantages Oral pills 1.2-40% depending on intrinsic factor Convenient, widely available Poor absorption, especially with age or GI issues Sublingual Slightly better than pills No need for intrinsic factor, easy to use Still less effective than injectable forms In-clinic IM injection Nearly 100% Highly effective, professionally administered Requires clinic visits, potential travel and waiting time At home B12 injection Nearly 100% Highly effective, convenient, no travel needed Requires training, prescription, and comfort with self-injection IV infusion 100% Immediate delivery to bloodstream Most expensive, requires professional administration For many people especially those with serious deficiencies, digestive disorders, or pernicious anemia at home B12 injection offers the sweet spot of effectiveness and convenience
Conclusions Collectively, FIB-4 has moderate diagnostic accuracy for identifying or excluding AF in NAFLD patients with T2DM, but more evidence must be accumulated due to the limited number of currently reported studies and their heterogeneity
Unlike quick-fix programs or fad diets, GLP-1 therapy targets the biological causes of weight gain
Read this guide to learn more about step therapy exceptions
