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Type 2 diabetes itself increases thrombotic risk due to endothelial dysfunction, inflammation, and associated cardiovascular risk factors independent of medication

As First-Line Treatment Guidelines increasingly support GLP-1 agonists as first-line treatment alongside or instead of metformin: When to consider first-line GLP-1: Established cardiovascular disease High cardiovascular risk Significant obesity (BMI 35+) Strong desire for weight loss Insurance coverage available Traditional metformin-first approach: Lower cost without insurance Decades of safety data Effective for many patients Can add GLP-1 later if needed For many patients, starting with a GLP-1 medication rather than metformin provides superior comprehensive benefit

It is not a GHRH analog it is a ghrelin mimetic, meaning it binds the ghrelin receptor (the same receptor activated by the hunger hormone)

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