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PGC-1 affects the peroxisome proliferator-activated receptor (PPAR), which contains nuclear transcription factors PPAR- (liver), PPAR- (skeletal muscle) and PPAR- (adipocytes), that fulfil the function of regulating the expression of genes involved in adipose metabolism such as pyruvate dehydrogenase kinase 4 (PDK4), phosphoenolpyruvate carboxykinase (PEPCK), adiponectin, perilipin and 6-phosphofructo-2-kinase/fructose-2,6-bisphosphatase 3 (PFKFB3), among others (Reference Nakamura, Yudell and Loor48,Reference Tometsuka, Koyama and Ishijima49)
Storage is carried out at 2 to 8 degrees Celsius, with the lyophilized product maintaining a shelf life of several years
The standard of care involves a multidisciplinary team consisting of a diabetologist, a gastroenterologist with motility expertise, a certified diabetes educator, a registered dietician and a behavioral psychologist and/or a psychiatrist
This difference reflects both the pen delivery system (which minimizes contamination risk compared to multi-puncture vials) and the extensive preservative efficacy testing conducted by the manufacturer
