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[] In addition, the insulin gene transcription process is stimulated by PKA and enhances insulin synthesis

Pratley RE, Aroda VR, Lingvay I, Ldemann J, Andreassen C, Navarria A et al (2018) Semaglutide versus dulaglutide once weekly in patients with type 2 diabetes (SUSTAIN 7): a randomised, open-label, phase 3b trial

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Similarly, changes in albuminuria appear as the strongest predictor of major kidney outcomes according to the Parameter Response Efficacy (PRE) score, an algorithm integrating several biomarkers of renal adverse events, as treatment with liraglutide resulted in a 16.2% estimated relative risk reduction (RRR) of kidney outcomes, similar to the observed RRR of 15.5%, which was mainly driven by UACR changes (RRR 13.2%) [15]

Other groups have also modified the primary sequence of glucagon to confer increased GLP-1R potency