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Eur Urol Focus 2019

However, some orally-administered drugs are able to avoid first-pass metabolism , to some degree at least, as a result of lymphatic drug absorption

The ominous octet (Defronzo model) includes: decreased muscle glucose uptake, increased hepatic glucose output, impaired incretin effect, alpha-cell hyperglucagonemia, increased renal glucose reabsorption (SGLT-2 upregulation), increased lipolysis (adipose), decreased central satiety signaling, and decreased beta-cell insulin secretion