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A bond can form between the S on cysteine and the glutamic acid carbonyl group, forming a ring structure
00:12:02 Vickie Danaher So if you spot a patient on both, clarify the plan with the prescriber and make sure that only one GLP-1 therapy is being used at a time
The dark blue circles in the terminal portion of tirzepatide are amino acids from exenatide, a protein-derived peptide (exendin-4) present in the venom of the Gila monster ( Heloderma suspectum ) and known to activate the receptor GLP-1
The effect is modest at the individual level but statistically robust across nearly 28,000 patients and replicated in an independent NIH All of Us cohort
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