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Two websites evaluated were sent FDA warning letters for unlawful sale of unapproved and misbranded semaglutide. Unfortunately, as the study also revealed, the business of these illegal online pharmacies has real-life consequences

Figure 16: Painting of Professor John C Brown (19382016) by his grandson, Matthew T Kieffer, credit: Kieffer

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However, the third-generation product glimepiride can not only stimulate insulin secretion but also increase insulin sensitivity

In a literature review by Araj-Khodaei et al., it was stated that Berberine induces GLP-1 insulin secretion by altering the gut biome, and promoting the secretion of short chain fatty acids in the large intestine [6]