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Baseline and periodic monitoring should include: Serum IGF-1 (target: mid-normal for age) Fasting glucose and HbA1c (GH antagonizes insulin action) [18] Lipid panel Assessment for fluid retention, arthralgias, and carpal tunnel symptoms The American Association of Clinical Endocrinology advises against GH-axis therapy in patients with active malignancy or uncontrolled diabetes [12]
Indeed, pancreatic nesidioblastosis (a hyperplasia of islet cells that is potentially driven by elevated secretion of GLP1) has been implicated in the pathogenesis of refractory hypoglycaemia
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Exenatide also had strong anhedonic effects in the same paradigms when injected directly into reward-related brain areas such as the ventral tegmental area (VTA), the nucleus accumbens (NAc), and even in the nucleus tractus solitarii (NTS), a structure previously thought to regulate homoeostatic feeding only [25,26,27,28,29]
It can also be prescribed to adolescents who are considered obese
