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GLP-1 medications are challenging to replicate

Both Epac1 and Epac2 are expressed in the pancreas (Leech et al., 2000), and under high glucose conditions, Ca 2+ flows into cells through VDC channels, and Epac2 opens RYR calcium channels in the endoplasmic reticulum, further increasing intracellular Ca 2+ concentrations and enhancing exocytosis of insulin-secreting vesicles (Weir et al., 1989)

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They added that a few people on the placebo arm had large amounts of weight loss, which may also complicate the analysis

Over 90% lost 10% of their body weight