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Additionally, her hyperphagia was quite severe, and medications with stronger mechanisms for appetite regulation (like GLP-1 RAs) were ultimately more impactful. Despite extensive evaluation for monogenic and syndromic causes of hyperphagia, a clear diagnosis was not reached

Lyophilized powder freezes fine for long-term storage, but once a peptide is in solution, ice crystals physically damage the structure you lose potency and get precipitation on thaw

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Gerstein HC, Colhoun HM, Dagenais GR, Diaz R, Lakshmanan M, Pais P et al (2019) Dulaglutide and cardiovascular outcomes in type 2 diabetes (REWIND): a double-blind, randomised placebo-controlled trial