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Technology trajectory: The field is converging on three next-generation directions: (1) oral small molecule GLP-1RAs (Lilly, Pfizer, Roche, Viking all in Phase 3), (2) multi-receptor co-agonists with superior efficacy (retatrutide, survodutide, GLP-1/FGF21 combos), and (3) biased agonism for improved tolerability (Sciwinds ecnoglutide as proof of concept)

His concerns come from past findings with IGBs: Over time, they stop working

Glutathione Fights Free Radicals Eventually, the pollution, UV rays, stress, and poor sleep will appear on your face

Premixed insulin may offer convenience for some but reduces treatment flexibility

Clinicians can prescribe but rarely have the time or bandwidth to coach on meals, sleep, stress, and habit change the way you do

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