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We hypothesize that the drastic inhibition of GLP-1 secretion via the shutdown of the main pathway through the SSTRs-Gi axis is the primary cause of pasireotide-induced hyperglycemia

From a clinical and applied standpoint, this supports the notion of moving toward cycle-aware, but not rigidly cycle-synced, strategies: for most healthy, well-nourished women, modest phase-dependent adaptationssuch as ensuring adequate energy and micronutrient intake in the mid-luteal phase, or considering the timing of high-intensity exercise relative to phases associated with lower subjective well-beingare likely to be sufficient, whereas in conditions such as PCOS, obesity, diabetes or functional hypothalamic amenorrhea, a more deliberate alignment of nutrition and training with endocrine and inflammatory profiles may help stabilize glycemic control, ovulatory function, and symptom burden [95,172]