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24 There is substantial evidence that GPL-1R may improve signal transduction by enhancing the PI3K/AKT pathway due to the anti-apoptotic effects of GLP-1 through modulation of transcription factor cyclic AMP response-binding protein (CREB) and protein survival factors like Bcl-2 and Bcl-XL, including -arrestin-1 and phosphorylation of ERK1/2