HOMA-IR

Insulin Sensitivity

Tirzepatide's insulin-sensitivity effect comes mostly from direct metabolic reprogramming, not weight loss. MOTS-c bypasses the insulin receptor entirely. The Khavinson bioregulators target β-cell regeneration via epigenetics. The three stories land at very different evidence grades — and the highest-impact decision in the whole class is sourcing.

Peptide therapy for insulin sensitivity now spans three distinct mechanistic classes: incretin agonists (GLP-1, tirzepatide, retatrutide) acting at the hormonal layer, mitochondrial-derived peptides (MOTS-c) acting at the cellular-energy layer via AMPK, and epigenetic bioregulators (Khavinson peptides, Pancragen) attempting to restore gene expression in β-cells. Weight loss explains only 13–21% of tirzepatide's HOMA-IR improvement — the rest is direct metabolic reprogramming. MOTS-c is an exercise mimetic in early trials. Bioregulators are a Russian-literature frontier awaiting Western replication. Sourcing is the biggest preventable harm in the whole class.