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10.1146/annurev.iy.11.040193.000541

Elevated GH levels subsequently trigger the liver to produce insulin-like growth factor 1 (IGF-1), which mediates many of GH's anabolic effects, including protein synthesis, lipolysis (fat breakdown), and tissue repair

However, in parallel, ghrelin and obestatin activate AMPK in hepatocytes, triggering mitochondrial free fatty acid (FFA) -oxidation [107, 141, 142]

Why this matters for India: Generic entry could unlock a 5,000+ crore opportunity over the next 1215 months Prices may drop 3050% initially, and potentially 7075% over time #GLP-1 adoption in diabetes care is expected to rise sharply, adding 0.51% to IPM growth in FY27 Competition is intensifying, with 1015 players vying for share across India, regulated, and emerging markets Novo Nordisk has already launched Ozempic in India (Dec 2025), setting the stage for one of the most closely watched generic transitions in recent pharma history