9 Research gaps and future priorities 9.1 Reproductive-oriented RCTs: shifting from metabolic surrogates to hard endpoints To date, most GLP-1RA trials in PCOS have been designed around metabolic efficacy (weight change and insulin-resistance/glycaemic indices) as the primary outcomes, with reproductive outcomesovulation, clinical pregnancy, and live birthreported inconsistently and often as secondary or exploratory measures
This means that high serum B12 levels can persist for some time after large supplemental doses
These additions may offer supplementary benefits, but they also mean the formulation you are injecting is not identical to what was tested in clinical trials
In the last year, for instance, several randomized controlled trials have found that a 'premeal' of whey protein (a by-product of the cheese-making process) can improve blood glucose and insulin levels for a short time thereafter
Torres Acosta MA, Singer BD
Step 5: Track your response