incretin comes up often in conversation and rarely with the context attached. Here we lay out the basics in order, then work through the practical considerations.
Last reviewed on 2026-02-12. Where a claim depends on a specific study, the study is described rather than over-claimed.
Receptor activation follows the canonical Gs pathway: binding increases intracellular cyclic AMP, which promotes protein kinase A activity. In pancreatic beta cells this amplifies glucose-dependent insulin release, so secretion rises when blood glucose is high and changes little when it is low. The same signalling suppresses glucagon release from alpha cells and slows gastric emptying. Receptors in the hypothalamus and brainstem are thought to contribute to reduced appetite and lower energy intake. Which of these effects dominates clinical outcomes remains an area of active study.
Semaglutide is a synthetic peptide analogue of glucagon-like peptide-1, a gut hormone released by intestinal L cells after food intake. The natural hormone acts on pancreatic and central receptors but is degraded within minutes by dipeptidyl peptidase-4 and other peptidases. Semaglutide belongs to the class of long-acting GLP-1 receptor agonists, a group distinguished by structural changes that slow breakdown and extend circulation time. Its development followed earlier short-acting analogues and reflects a general strategy in peptide drug design: preserve receptor activity while blocking proteolytic clearance.
Three structural changes define the molecule. At position 8 an alpha-aminoisobutyric acid residue replaces alanine, which blocks dipeptidyl peptidase-4 cleavage. At position 34 arginine replaces lysine, and at position 26 a lysine carries a C18 fatty diacid attached through a short linker. The fatty chain binds serum albumin, and this albumin association reduces renal filtration and enzymatic attack. The unchanged backbone retains the receptor contacts that produce signalling. The free base has the formula C187H291N45O59 and a molecular weight near 4114 daltons.
Degradation proceeds along several parallel routes. Deamidation of asparagine and glutamine residues generates charged variants that shift retention time in chromatographic analysis. Oxidation targets methionine and can be accelerated by trace metals or dissolved oxygen. Non-covalent aggregation produces dimers, oligomers, and larger species that are difficult to reverse. Isomerisation at aspartate residues is slower but measurable under thermal stress. The distribution among these pathways depends on pH, buffer composition, ionic strength, and the presence of excipients such as sugars or surfactants.
Reverse-phase high-performance liquid chromatography with ultraviolet detection near 214 nm is the standard purity method, reported as area percent. Mass spectrometry, usually with electrospray ionisation, confirms identity and reveals covalent modifications. Size-exclusion chromatography quantifies aggregates and fragments. Peptide mapping after enzymatic digestion localises changes to specific sequence regions. Circular dichroism and infrared spectroscopy report on secondary structure, while light scattering tracks particle formation in liquid formulations. No single technique captures every quality attribute.
| Property | Value | Notes |
|---|---|---|
| Molecular formula | C187H291N45O59 | free base, without counter-ion |
| Molecular weight | About 4114 Da | peptide backbone plus attached lipid chain |
| Plasma half-life | About 165 hours | supports once-weekly dosing in humans |
| Plasma protein binding | Greater than 99 percent | attributed mainly to serum albumin |
| Receptor target | GLP-1 receptor | Gs-coupled, raises intracellular cyclic AMP |
Clinical development of this compound followed earlier short-acting GLP-1 analogues that required frequent injection. Once-weekly subcutaneous formulations entered use after 2017, and an oral formulation using a permeation enhancer later became available. The oral version pairs the peptide with sodium N-(8-[2-hydroxybenzoyl] amino) caprylate, a carrier that improves uptake across the gastric epithelium. Interest has expanded from glycaemic control into weight management and metabolic liver disease. Regulatory status and approved indications differ between countries, and the product remains subject to ongoing safety monitoring.
Semaglutide is a synthetic peptide that acts as an agonist at the glucagon-like peptide-1 receptor. It is a structural analogue of human GLP-1(7-37), modified to resist enzymatic degradation by dipeptidyl peptidase-4. The peptide backbone contains alpha-aminoisobutyric acid at position 8, a substitution that stabilises the helix and slows cleavage. A fatty diacid side chain attached through a linker at lysine 34 promotes binding to serum albumin, which extends the circulating half-life. These two modifications together allow less frequent administration than native GLP-1 requires.
Activation of the GLP-1 receptor couples to Gs signalling and raises intracellular cyclic AMP in pancreatic beta cells. The resulting insulin release depends on prevailing glucose concentrations, so the effect is greater when glucose is elevated. Receptor engagement also suppresses glucagon secretion and slows gastric emptying, which flattens post-meal glucose excursions. In the central nervous system, signalling in hypothalamic and brainstem regions is associated with reduced appetite and lower energy intake. Studies continue to examine effects on cardiac, renal and hepatic endpoints; whether those benefits are independent of weight change remains an open question.
GLP-1 receptors are expressed on pancreatic beta cells, in the gut, and in several brain regions. Receptor activation raises cyclic AMP, enhances glucose-dependent insulin secretion, and suppresses glucagon release when blood glucose is high. Effects on gastric emptying and on hypothalamic appetite circuits reduce energy intake. Because insulin release remains glucose-dependent, the risk of hypoglycemia is low when the drug is used alone. The precise contribution of each pathway to body weight change in humans remains an area of active investigation.
Clinical studies of semaglutide generally measure glycated hemoglobin, fasting plasma glucose, body weight, and composite cardiovascular endpoints. The SUSTAIN program enrolled adults with type 2 diabetes, while the STEP program focused on obesity without diabetes. Administration follows a stepwise escalation schedule designed to limit gastrointestinal effects during the first weeks. Reported outcomes include mean percentage weight change, the proportion of participants reaching defined weight-loss thresholds, and rates of nausea, vomiting, and diarrhea. Long-term data on durability after treatment stops are still limited and remain a topic of ongoing research.
Semaglutide is a synthetic peptide analog of human glucagon-like peptide-1, developed by Novo Nordisk and first approved in 2017 for type 2 diabetes. It belongs to the incretin mimetic class, a group of agents that reproduce the glucose-dependent actions of endogenous GLP-1. The molecule was engineered to resist degradation by dipeptidyl peptidase-4 and to bind serum albumin, extending its half-life from minutes to roughly one week. Approval for chronic weight management followed in 2021, based on large cardiovascular and obesity outcome trials.
Statehood for Salisbury without majority rule would split the Commonwealth and perhaps cause it to break up, a disastrous prospect for British foreign policy. The Commonwealth repeatedly called on Britain to intervene directly should Southern Rhodesian defiance continue, while liberals in Britain worried that if left unchecked Salisbury might drift towards South African-style apartheid. Anxious to avoid having to choose between Southern Rhodesia and the Commonwealth, Whitehall attempted to negotiate a middle way between the two, but ultimately put international considerations first, regarding them as more important. At party level, the Labour Party, in opposition until October 1964, was overtly against Southern Rhodesian independence under the 1961 constitution and supportive of the black Rhodesian movement on ideological and moral grounds. The Liberal Party, holding a handful of parliament seats, took a similar stance. The Conservative Party, while also following a policy of decolonisation, was more sympathetic to the Southern Rhodesian government's position, and included members who openly supported it.
== Anatomy of the eyelids == Blepharoplasty involves modification of the anatomical structures of the upper and lower eyelids to improve both function and appearance. A detailed understanding of eyelid anatomy is essential for preserving eyelid support, maintaining normal closure and achieving natural, balanced results.
Neuroleptic malignant syndrome (NMS) is a rare but life-threatening reaction that can occur in response to ingesting antipsychotics (neuroleptics) or other drugs that block the effects of dopamine. Symptoms include high fever, confusion, rigid muscles, variable blood-pressure, sweating, and fast heart-rate. Complications may include muscle breakdown (rhabdomyolysis), high blood potassium, kidney failure, or seizures. Any medications within the family of antipsychotics can cause the condition, though typical antipsychotics appear to entail a higher risk than atypicals, specifically first-generation antipsychotics like haloperidol. Onset is often within a few weeks of starting the medication but can occur at any time. Risk factors include dehydration, agitation, and catatonia. Rapidly decreasing the use of levodopa or other dopamine agonists, such as pramipexole, may also trigger the condition. The underlying mechanism involves blockage of dopamine receptors. Diagnosis is based on symptoms. Management includes stopping the triggering medication, rapid cooling, and starting other medications. Medications used include dantrolene, bromocriptine, and diazepam. The risk of death among those affected is about 10%. Rapid diagnosis and treatment is required to improve outcomes. Many people can eventually be restarted on a lower dose of antipsychotic. As of 2011, about 15 per 100,000 (0.015%) patients in psychiatric hospitals on antipsychotics are affected per year. In the second half of the 20th century rates were over 100 times higher at about 2% (2,000 per 100,000).
The idea of "no independence before majority rule", commonly abbreviated to "NIBMAR", gained considerable ground in British political circles. When Huggins (who had been recently ennobled as Lord Malvern) asked Britain to make the Federation a dominion in 1956, he was rebuffed. The opposition Dominion Party responded by repeatedly calling for a Federal unilateral declaration of independence (UDI) over the next few years. Following Lord Malvern's retirement in late 1956, his successor Sir Roy Welensky pondered such a move on at least three occasions. Attempting to advance the case for Southern Rhodesian independence, particularly in the event of Federal dissolution, the Southern Rhodesian Prime Minister Sir Edgar Whitehead brokered the 1961 constitution with Britain, which he thought would remove all British powers of reservation over Southern Rhodesian bills and acts, and put the country on the brink of full sovereignty. Despite its containing no independence guarantees, Whitehead, Welensky and other proponents of this constitution presented it to the Southern Rhodesian electorate as the "independence constitution" under which Southern Rhodesia would become a dominion on a par with Australia, Canada and New Zealand if the Federation dissolved. White dissenters included Ian Smith, MP for Gwanda and Chief Whip for the governing United Federal Party (UFP) in the Federal Assembly, who took exception to the constitution's omission of an explicit promise of Southern Rhodesian independence in the event of Federal dissolution, and ultimately resigned his post in protest.
=== Inverted lymph nodes === Some mammal species, such as pigs, rhinoceroses, hippopotamuses, and certain cetaceans, have so-called "inverted" lymph nodes. In these nodes, the afferent lymph carries antigens from the center (where the B-cell follicles are located) toward the periphery. Mature B and T lymphocytes exit the lymph node from its periphery directly into the general bloodstream via efferent venules. These structural differences do not appear to impact the functionality of the lymph nodes.
Sources: en.wikipedia.org
Topical formulations of diphenhydramine are available, including creams, lotions, gels, sprays, and eye drops. These are used to relieve itching and have the advantage of causing fewer systemic effects (such as drowsiness) than oral forms.
2 October A U.S. Navy C-2A Greyhound crashed into the Gulf of Tonkin on a flight from Naval Air Station Cubi Point to the aircraft carrier USS Constellation killing all 27 on board. Hanna E. Crews a Donut Dolly died of head injuries after a vehicle accident near Bien Hoa, becoming the first of three Donut Dollies to die in the war.
Stark Law is a set of United States federal laws that prohibit physician self-referral, specifically a referral by a physician of a Medicare or Medicaid patient to an entity for the provision of designated health services ("DHS") if the physician (or an immediate family member) has a financial relationship with that entity. The term "referral" means "the request by a physician for the item or service" for Medicare Part B services and "the request or establishment of a plan of care by a physician which includes the provision of the designated health service" for all other services. DHS includes "clinical laboratory services"; "physical therapy services"; "occupational therapy services"; "radiology services, including magnetic resonance imaging, computerized axial tomography scans, and ultrasound services"; "radiation therapy services and supplies"; "durable medical equipment and supplies"; "parenteral and enteral nutrients, equipment, and supplies"; "prosthetics, orthotics, and prosthetic devices and supplies"; "home health services"; "outpatient prescription drugs"; "inpatient and outpatient hospital services"; and "outpatient speech-language pathology services." A "financial relationship" includes ownership, investment interest, and compensation arrangements. The Stark Law contains several exceptions, including physician services, in-office ancillary services, ownership in publicly traded securities and mutual funds, rental of office space and equipment, and bona fide employment relationship.
Chemically, levorphanol belongs to the morphinan class and is (−)-3-hydroxy-N-methyl-morphinan. It is the "left-handed" (levorotatory) stereoisomer of racemorphan, the racemic mixture of the two stereoisomers with differing pharmacology. The "right-handed" (dextrorotatory) enantiomer of racemorphan is dextrorphan (DXO), an antitussive, potent dissociative hallucinogen (NMDA receptor antagonist), and weakly active opioid. DXO is an active metabolite of the pharmaceutical drug dextromethorphan (DXM), which, analogously to DXO, is an enantiomer of the racemic mixture racemethorphan along with levomethorphan, the latter of which has similar properties to those of levorphanol.
is the dosing interval, ss means steady state and 1 stands for a single-dose application. Another definition sets Rac to the ratio of the average drug concentration during one day under steady state conditions to the concentration after a single dose.
Sources: en.wikipedia.org
=== Kurie plot === A Kurie plot (also known as a Fermi–Kurie plot) is a graph used in studying beta decay developed by Franz N. D. Kurie, in which the square root of the number of beta particles whose momentum (or energy) lies within a certain narrow range, divided by the Fermi function, is plotted against beta-particle energy. It is a straight line for allowed transitions and some forbidden transitions, in accord with the Fermi beta-decay theory. The energy-axis (x-axis) intercept of a Kurie plot corresponds to the maximum energy imparted to the electron/positron (the decay's Q value). With a Kurie plot one can find the limit on the effective mass of a neutrino.
=== International locations === The first location outside of North America opened in the United Kingdom on July 4, 2013, in London on Long Acre in Covent Garden. The chain now has more than 170 restaurants in the United Kingdom. In 2017, Five Guys opened its first restaurants in Germany, with a branch in Frankfurt and another in Essen. Five Guys opened its first Korean store in Gangnam, Seoul in 2023, with a countdown shout, and expanded to four branches in Seoul. In 2021, Five Guys opened their first location in Australia. The chain also has plans to expand into New Zealand. In 2025, Five Guys announced that it would open their first restaurant in Denmark, at Fisketorvet, a shopping mall in Copenhagen. In 2026, the number of stores per country was as follows:
During World War II, German Type XXI submarines (also known as "Elektroboote") were the first submarines designed to operate submerged for extended periods. Initially they were to carry hydrogen peroxide for long-term, fast air-independent propulsion, but were ultimately built with very large batteries instead. At the end of the War, the British and Soviets experimented with hydrogen peroxide/kerosene (paraffin) engines that could run surfaced and submerged. The results were not encouraging. Though the Soviet Union deployed a class of submarines with this engine type (codenamed Quebec by NATO), they were considered unsuccessful. The United States also used hydrogen peroxide in an experimental midget submarine, X-1. It was originally powered by a hydrogen peroxide/diesel engine and battery system until an explosion of her hydrogen peroxide supply on 20 May 1957. X-1 was later converted to use diesel–electric drive. Today several navies use air-independent propulsion. Notably Sweden uses Stirling technology on the Gotland-class and Södermanland-class submarines. The Stirling engine is heated by burning diesel fuel with liquid oxygen from cryogenic tanks. A newer development in air-independent propulsion is hydrogen fuel cells, first used on the German Type 212 submarine, with nine 34 kW or two 120 kW cells. Fuel cells are also used in the new Spanish S-80-class submarines although with the fuel stored as ethanol and then converted into hydrogen before use.
When exposed to neutron bombardment 237Np can capture a neutron, undergo beta decay, and become 238Pu, this product being useful as a thermal energy source in a radioisotope thermoelectric generator (RTG or RITEG) for the production of electricity and heat. The first type of thermoelectric generator SNAP (Systems for Nuclear Auxiliary Power) was developed and used by NASA in the 1960's and during the Apollo missions to power the instruments left on the Moon surface by the astronauts. Thermoelectric generators were also embarked on board of deep space probes such as for the Pioneer 10 and 11 missions, the Voyager program, the Cassini–Huygens mission, and New Horizons. They also deliver electrical and thermal power to the Mars Science Laboratory (Curiosity rover) and Mars 2020 mission (Perseverance rover) both exploring the cold surface of Mars. Curiosity and Perseverance rovers are both equipped with the last version of multi-mission RTG, a more efficient and standardized system dubbed MMRTG. These applications are economically practical where photovoltaic power sources are weak or inconsistent due to probes being too far from the sun or rovers facing climate events that may obstruct sunlight for long periods (like Martian dust storms). Space probes and rovers also make use of the heat output of the generator to keep their instruments and internals warm.
Sources: en.wikipedia.org
Native GLP-1 is a short-lived peptide cleared within one to two minutes by dipeptidyl peptidase-4 and related enzymes. Semaglutide keeps the receptor-binding backbone but adds substitutions and a lipid chain. These changes block the main cleavage site and allow reversible albumin binding, extending the half-life to roughly 165 hours.
Albumin is the most abundant protein in plasma and carries molecules that bear fatty-acid chains. Binding shields the peptide from renal filtration and from peptidases, keeping a circulating reservoir. Slow release from this reservoir produces sustained receptor occupancy and supports infrequent dosing.
The insulinotropic effect is glucose-dependent, meaning secretion increases mainly when glucose is elevated. This property is often described as lowering the chance of hypoglycaemia when the compound is used alone. Other glucose-lowering agents used at the same time can still cause low blood glucose.
Reverse-phase high-performance liquid chromatography with ultraviolet detection is the usual choice, with results reported as area percent. Complementary methods such as size-exclusion chromatography and mass spectrometry are needed because a single separation cannot resolve every impurity class. Purity figures are therefore method dependent and should always be read alongside the technique used.