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Ipamorelins selective GHS-R1a agonism drives GH granule exocytosis from somatotrophs through Gq/11-PLC-IP3-calcium mobilisation , the identical intracellular signalling cascade engaged by non-selective first-generation GH secretagogues and but does so without producing the off-target receptor engagement at pituitary lactotrophs and corticotrophs that drives prolactin and cortisol co-secretion following GHRP-6 and GHRP-2 administration

In addition, differences in the initial situation of gastric emptying, which is a measure of the effectiveness of GLP- 1- receptor co-agonists, are likely to have a different effect on patients with obesity than on people in whom preoperative intragastric food retention after taking GLP- 1 receptor co-agonists is not impaired, and in people with diabetes [127]

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