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Common approaches include continuous use, 5-days-on/2-days-off schedules, or cycling (e.g., 8-12 weeks on, 2-4 weeks off)

Tesamorelin mitigates this through pulsatile release (avoiding the sustained supraphysiological GH levels that direct injection creates), and clinical trials in type 2 diabetic patients showed no significant changes in glucose control

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The commonly used systemic agents with their routes of administration are tabulated below [Table 1]

Thisse C, Degrave A, Kryukov GV, Gladyshev VN, Obrecht-Pflumio S, Krol A, Thisse B, Lescure A

For example, methylglyoxal, an enzymatic, and non-enzymatic product deriving from the glycolytic pathway (Martins et al., 2001