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[9] [2] According to NICE guidance, patients with confirmed B12 deficiency and neurological involvement typically require more frequent initial dosing (alternate-day injections) until symptom improvement occurs
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In addition, GLP-1R stimulation activates insulin signaling pathways and regulates gene expression, decreasing systemic insulin resistance and brain insulin resistance in patients with AD (Dahiya et al., 2025)
It was through that experience, and the conversations that followed about her skin, that she first learned about GLP-1 medications
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The trial anchors are STEP for semaglutide ( NEJM , 2021), SURMOUNT for tirzepatide ( NEJM , 2022), and SURMOUNT-OSA for tirzepatide in sleep apnea ( NEJM , 2024)
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