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In terms of safety and tolerability, the adverse events were primarily mild to moderate gastrointestinal reactions, with no reports of severe hypoglycemia or death.161 In summary, dual and triple agonists related to GLP-1 represent significant advances in the field of diabetes treatment,167,168 demonstrating the future trend of enhancing therapeutic effects by targeting multiple biomarkers.136,169,170 With the accumulation of more clinical data and the development of new drugs, these treatment options are expected to provide more effective and comprehensive treatment choices for diabetes patients.161,167 GLP-1 .124,125,126 , , .43 , .127,128 GLP-1R .124,129 GLP-1 GIP .130 , ( Mounjaro) GLP-1 GIPR .124 GLP-1 .131,132,133 , GLP-1 .121,134 GIP , GLP-1 .125,130 2022, 2 FDA .135,136 , .135 , T2DM .136,137,138 , .139,140,141 , .141 , .141,142 3 , , 7 77 .143 2 , .143 , 2

Various factors are involved in the fluctuations and stabilities in bacterial levels, such as nutrient availability, temperature, osmolality, pH, and bacteriophages, which are viruses that infect bacteria 20,21,22,23

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