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It is also possible that in active acromegaly, chronic exposure to elevated IGF-I levels resets IGF-IR responsiveness via the induction of IGF-IR resistance (70), as it has been demonstrated that prolonged stimulation with IGF-I induces functional IGF-IR resistance in vitro through the negative feedback loop (72)

The glucagon component, in particular, helps explain why some patients respond differently to GLP-1 therapy, and why medications sometimes stop working

Vitamin B12, also referred to as cobalamin plays a role as a water soluble vitamin in the production of red blood cells, brain function and DNA synthesis