If you have been reading about incretin and want a single page that covers the useful parts, this is it: definitions, context, how it is studied, and the questions that come up repeatedly.
Updated 2026-06-23. Numbers and descriptions here follow the published literature rather than marketing material.
Reported outcomes in large trials include dose-dependent weight reduction and improvements in glycemic markers over periods ranging from several months to more than a year. Whether the compound alters long-term cardiovascular or renal outcomes is being examined in dedicated outcome studies, so those questions remain open. Labeling describes gastrointestinal effects such as nausea and diarrhea, which tend to appear during dose escalation. Discontinuation rates and the durability of effects after treatment stops vary across study populations and are still debated.
Tirzepatide is a synthetic peptide developed as a dual agonist at the glucose-dependent insulinotropic polypeptide and glucagon-like peptide-1 receptors. Its structure is built on a GIP-derived backbone with non-natural amino acid substitutions and a fatty diacid side chain that promotes albumin binding and slows clearance. That modification supports once-weekly subcutaneous dosing. Registrational trial programs reported reductions in body weight and glycated hemoglobin alongside the drug's glycemic effects.
Both receptors are class B G protein-coupled receptors that signal largely through Gs-mediated cyclic AMP production. Activation within pancreatic islets increases glucose-dependent insulin secretion and suppresses glucagon release when glucose is elevated. Outside the pancreas, signaling in the central nervous system and gut appears to influence appetite and gastric emptying. The relative contribution of each receptor to observed clinical effects remains under investigation, and the two pathways are not simply additive in practice.
Development began in the 2010s, when researchers modified a GIP-based scaffold to add GLP-1 activity and then attached the fatty diacid to lengthen its half-life. Clinical evaluation proceeded through large phase 3 programmes in type 2 diabetes and in obesity, and regulators in the United States cleared the compound for type 2 diabetes in 2022 and for chronic weight management in 2023. Several cardiovascular and metabolic outcome studies are still reporting, so the picture of long-term benefit and risk is incomplete. Approvals in other regions followed on different timelines.
Tirzepatide is a synthetic peptide of 39 amino acids that carries a C20 fatty diacid side chain attached through a linker. Its molecular formula is C225H348N48O68, and its molecular weight is about 4813 daltons. The compound belongs to the incretin mimetic class and is administered by subcutaneous injection. The fatty acid chain promotes binding to serum albumin, which slows renal clearance and extends the circulation time of the molecule. It was identified during screening of sequences derived from glucose-dependent insulinotropic polypeptide.
| Property | Value | Notes |
|---|---|---|
| Molecular class | Synthetic 39-residue peptide | GIP-derived backbone with non-natural residues |
| Molar mass | Approximately 4.8 kDa | Peptide chain plus linker and lipid modifications |
| Appearance | White to off-white powder | Typical of lyophilized research material |
| Solubility | Soluble in water and aqueous buffer | Practically insoluble in nonpolar solvents |
| Storage temperature | Typically −20 °C for dry powder | Solutions usually held at 2–8 °C short term |
The GIP receptor is expressed in pancreatic islets, adipose tissue, and the central nervous system, while GLP-1 receptors are found in pancreatic islets, the gastrointestinal tract, and the brain. Activation of both receptors can enhance glucose-dependent insulin secretion and reduce glucagon release. The relative contribution of each receptor to the overall pharmacological effect remains an area of ongoing investigation. Preclinical studies suggest that GIP receptor agonism may modulate appetite and energy balance, but the precise mechanisms in humans are not fully established.
In clinical research, tirzepatide has been studied in randomized controlled trials for glycemic control and body weight reduction. These trials typically measure changes in hemoglobin A1c and body weight over periods of several months. The drug is administered by subcutaneous injection, and its pharmacokinetic profile supports once-weekly dosing. Post-marketing surveillance continues to evaluate long-term outcomes and rare adverse events.
Tirzepatide is a synthetic peptide that acts as a dual agonist at the glucose-dependent insulinotropic polypeptide (GIP) and glucagon-like peptide-1 (GLP-1) receptors. The molecule contains 39 amino acids and features a C20 fatty diacid moiety attached via a linker, which promotes albumin binding and extends its circulating half-life. Its sequence incorporates non-natural amino acids and modifications that reduce susceptibility to degradation by dipeptidyl peptidase-4. This dual receptor activity distinguishes it from selective GLP-1 receptor agonists.
Tirzepatide is a synthetic peptide built from thirty-nine amino acids. Its sequence is derived from native glucose-dependent insulinotropic polypeptide, or GIP, with several non-natural residues and a fatty diacid side chain attached through a linker. The molecule behaves as a dual agonist at two incretin receptors, GIP and GLP-1, instead of targeting a single receptor. This dual engagement separates it from earlier single-receptor incretin compounds and underpins most of its reported pharmacological activity.
At the receptor level, the compound binds both GIP and GLP-1 receptors and triggers downstream signalling that raises cyclic AMP in target cells. GLP-1 receptor activation is associated with glucose-dependent insulin release, slower gastric emptying, and reduced appetite signalling. GIP receptor activation contributes effects that are less completely characterised, and how much each receptor adds to the overall clinical response is still an open question. The two pathways appear to interact in a complementary rather than a purely additive way.
=== Oxides === Two oxides of berkelium are known, with the berkelium oxidation state of +3 (Bk2O3) and +4 (BkO2). Berkelium(IV) oxide is a brown solid, while berkelium(III) oxide is a yellow-green solid with a melting point of 1920 °C and is formed from BkO2 by reduction with molecular hydrogen:
== Mechanism of action == Dalbavancin is a lipoglycopeptide belonging in the same glycopeptide class as vancomycin. Similar to other glycopeptides, dalbavancin exerts its bactericidal effect by disrupting cell wall biosynthesis. It binds to the D-alanyl-D-alanyl residue on growing peptidoglycan chains and prevents transpeptidation from occurring, preventing peptidoglycan elongation and cell wall formation. Dalbavancin also dimerizes and anchors itself in the lipophilic bacterial membrane, thereby increasing its stability in the target environment and its affinity for peptidoglycan. Antimicrobial activity correlates with the ratio of area under the concentration-time curve to minimum inhibitory concentration for Staphylococcus aureus.
==== Contact with anti-Chiang organizations ==== Liu was reportedly influenced by the Xi'an Incident and the formation of the Second United Front in 1936, noting that the Communist Party was emerging as a major force in the country. In 1938, Liu Wenhui then reportedly established contact with the Communist Party's Southern Bureau through his in-laws, including general Zhang Zhihe. Zhang Zhihe would become a member of the Central Committee of the China Democratic League (CDL). Another CDL Central Committee member he was in close contact with was Zheng Shufan. Around the time of its establishment in 1941, Liu began providing financial support to the CDL. In September 1944, Liu joined the China Democratic League, becoming a Central Committee member in 1945. Liu's membership, influenced by fellow Sichuan native and CDL chairman Zhang Lan, was kept secret. Peng Dixian, who would later become one of Liu's main biographers, asserts that he established a branch of the CDL in Xikang under Liu's auspices, serving as its chairman. Liu and the CDL would cooperate closely during the later Chengdu Uprising. Over the course of the war with Japan, Liu had also been in contact with generals Li Jishen and Feng Yuxiang, who established the Revolutionary Committee of the Chinese Kuomintang (RCCK) in January 1948. On the urging of Li Jishen, Liu joined in the summer of 1948 as an underground member of the RCCK, becoming the Chairman of its Sichuan branch.
Mohs surgery, developed in 1938 by general surgeon Frederic E. Mohs, is microscopically controlled surgery used to treat both common and rare types of skin cancer. During the surgery, after each removal of tissue and while the patient waits, the tissue is examined for cancer cells. That examination dictates the decision for additional tissue removal. Mohs surgery is the gold standard method for obtaining complete margin control during removal of a skin cancer (complete circumferential peripheral and deep margin assessment using frozen section histology). This method allows for the removal of skin cancer with a very narrow surgical margin and a high cure rate. The cure rate with Mohs surgery cited by most studies is between 97% and 99.8% for primary basal-cell carcinoma, the most common type of skin cancer. Mohs procedure is also used for squamous cell carcinoma, but with a lower cure rate. Recurrent basal-cell cancer has a lower cure rate with Mohs surgery, more in the range of 94%. It has been used in the removal of melanoma-in-situ (cure rate 77% to 98% depending on surgeon), and certain types of melanoma (cure rate 52%). Other indications for Mohs surgery include dermatofibrosarcoma protuberans, keratoacanthoma, spindle cell tumors, sebaceous carcinomas, microcystic adnexal carcinoma, merkel cell carcinoma, Paget's disease of the breast, atypical fibroxanthoma, and leiomyosarcoma. Because the Mohs procedure is micrographically controlled, it provides precise removal of the cancerous tissue, while healthy tissue is spared.
==== Inkjet printing ==== Inkjet printing is used for surface filling or image decoration. By utilizing gravity, edible food ink is dropped onto the surface of the food, typically a cookie, cake, or other candy. This is a non-contact method, hence the printhead does not touch the food protecting the food from contamination during image filling. The ink droplets may consist of a broad range of colors allowing users to create unique and individualized food images. An issue with inkjet printing is the food materials being incompatible with the ink resulting in no image or high image distortion. Inkjet printers can be purchased for household or commercial use, and industrial printers are suitable for mass production.
Sources: en.wikipedia.org
A "stop" traffic sign with three 3D military drones painted on by Banksy is unveiled. The artwork has an anti-war theme believed to be relating to the Gaza war. However, it is stolen one hour after its unveiling in Peckham, London. 23 December The Metropolitan Police launches an investigation after a street sign in Peckham, London featuring the work of Banksy is stolen. A man is arrested on suspicion of theft and criminal damage during the first day of investigation. An increase in environmental activists being referred to the Prevent terrorism programme is reported, following the recent rise in disruptive climate protests. 24 December A second man is arrested on suspicion of theft and criminal damage after a road sign featuring work by street artist Banksy was stolen. Home Secretary James Cleverly apologises for a joke about his wife in which he said, "a little bit of Rohypnol in her drink every night" is "not really illegal", just hours after the Home Office announced plans to crack down on spiking. Two teenagers die and three others are injured in a three-car crash in Cramlington, Northumberland. The warmest Christmas Eve since 1997 is recorded, with temperatures of up to 15.3 °C (59.5 °F). British businessman Sir Jim Ratcliffe agrees a deal worth an estimated £1.3bn to buy a 25% share in Manchester United. The Ministry of Defence confirms that HMS Trent will take part in joint military exercises in Guyana in early 2024 as Venezuela renews its claims in the Guyana–Venezuela territorial dispute.
2019: New Zealand chemist Margaret Brimble is the first New Zealand woman to be inducted into the Division of Medicinal Chemistry of the American Chemical Society’s Hall of Fame. 2019: Malawian nurse and educator Address Malata is appointed as Vice-Chancellor of the Malawi University of Science and Technology (MUST), becoming the first Malawian women university Vice-Chancellor. 2019: American imaging scientist Katie Bouman developed an algorithm that made the first visualization of a black hole possible using the Event Horizon Telescope. She was part of the team of over 200 people who implemented the project.
=== Sources === Beynon, Erdmann Doane (May 1, 1938). "The Voodoo Cult among Negro migrants in Detroit". American Journal of Sociology. 43 (6): 894–907. doi:10.1086/217872. JSTOR 2768686. S2CID 144039917. Evanzz, Karl (2011) [1999]. The Messenger: The Rise and Fall of Elijah Muhammad (3 ed.). New York City, New York, United States: Knopf Doubleday. ISBN 9780307805201 – via Google Books. Gardell, Mattias (1996). In the Name of Elijah Muhammad: Louis Farrakhan and The Nation of Islam. Durham: Duke University Press. ISBN 978-0822318453.
The heart receives nerve signals from the vagus nerve and from nerves arising from the sympathetic trunk. These nerves act to influence, but not control, the heart rate. Sympathetic nerves also influence the force of heart contraction. Signals that travel along these nerves arise from two paired cardiovascular centres in the medulla oblongata. The vagus nerve of the parasympathetic nervous system acts to decrease the heart rate, and nerves from the sympathetic trunk act to increase the heart rate. These nerves form a network of nerves that lies over the heart called the cardiac plexus. The vagus nerve is a long, wandering nerve that emerges from the brainstem and provides parasympathetic stimulation to a large number of organs in the thorax and abdomen, including the heart. The nerves from the sympathetic trunk emerge through the T1–T4 thoracic ganglia and travel to both the sinoatrial and atrioventricular nodes, as well as to the atria and ventricles. The ventricles are more richly innervated by sympathetic fibers than parasympathetic fibers. Sympathetic stimulation causes the release of the neurotransmitter norepinephrine (also known as noradrenaline) at the nerve terminals contacting the cardiac muscle cells. This shortens the repolarisation period, thus speeding the rate of depolarisation and contraction, which results in an increased heart rate. It opens chemical or ligand-gated sodium and calcium ion channels, allowing an influx of positively charged ions. Norepinephrine binds to the beta–1 receptor.
Sources: en.wikipedia.org
The tomato (US: , UK: ; Solanum lycopersicum) is a plant whose fruit is an edible berry that is eaten as a vegetable. The tomato is a member of the nightshade family that includes tobacco, potato, and chili peppers. It originated from western South America, and may have been domesticated there, in Mexico, or in Central America. The Spanish introduced tomatoes to Eurasia in the Columbian exchange in the 16th century. Tomato plants are vines, largely annual, and vulnerable to frost, though sometimes living longer in greenhouses. The flowers can self-fertilize. Modern varieties have been bred to ripen uniformly red, in a process that has impaired the fruit's sweetness and flavor. There are thousands of cultivars, varying in size, color, shape, and flavor. Tomatoes are attacked by many insect pests and nematodes and are subject to diseases caused by viruses, mildew, and blight fungi. The tomato has a strong savory umami flavor and is an important ingredient in cuisines around the world. Tomatoes are widely used in sauces for pasta and pizza, in soups such as gazpacho and tomato soup, in salads and condiments like salsa and ketchup, and in various curries. Tomatoes are also consumed as juice and in beverages such as the Bloody Mary cocktail.
== Medical procedures == Physical lipolysis involves destruction of fat cells containing the fat droplets and can be used as part of cosmetic body contouring procedures. Currently there are four main non-invasive body contouring techniques in aesthetic medicine for reducing localized subcutaneous adipose tissue in addition to the standard minimally invasive liposuction: low-level laser therapy (LLLT), cryolipolysis, radio frequency (RF) and high-intensity focused ultrasound (HIFU). However, they are less effective with shorter lasting benefits and can remove significantly smaller amounts of fat compared to traditional surgical liposuction or lipectomy. However, future drug developments can be potentially combined with smaller procedures to augment the result.
Noriega's rule became increasingly repressive, even as the U.S. government of Ronald Reagan began relying on him in its covert efforts to undermine Nicaragua's Sandinista government. The U.S. accepted Barletta's election, and signalled a willingness to cooperate with him, despite being aware of the flaws in the election process.
Sources: en.wikipedia.org
It acts as an agonist at both the GIP and GLP-1 receptors, two related class B G protein-coupled receptors. This dual activity distinguishes it from single-receptor GLP-1 agonists. The clinical consequences of engaging both receptors are still being characterized.
It is given by subcutaneous injection, generally on a weekly schedule. Dosing usually begins low and increases in steps to limit gastrointestinal side effects. Formulated product is supplied as a ready-to-use pen or vial in most markets.
No. Receptor engagement is documented, but how central appetite circuits, gut signals, and insulinotropic effects combine is incompletely resolved. Investigators continue to separate GIP-driven from GLP-1-driven contributions in animal and human models.
It is a synthetic 39-amino-acid peptide that acts on two incretin receptors, the GIP receptor and the GLP-1 receptor. It is given by subcutaneous injection and has a circulating half-life of roughly five days. It is not a small molecule and is not absorbed usefully from the gut in conventional oral form.