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Symptoms can be diverse, fluctuating, and not all are exclusively due to hormonal changes
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GIP-induced cAMP production is blunted when rat or human pancreatic islets are cultured under conditions of high glucose, and treatment of isolated islets with the proteasomal inhibitors lactacystin or MG-132 prevents glucose-stimulated downregulation of Gipr , and preserves GIP-induced cAMP production, suggesting that hyperglycemia promotes degradation of GIPR by stimulating its ubiquitination [170]
This approach helps reduce gastrointestinal side effects, which are common with GLP-1 receptor agonists
