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The difference in chemical structure between this peptide and the original IGF-1 is the substitution of arginine at the third position, which significantly modifies the compound

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The serendipitous discovery of exendin-4 led to the development of exenatide immediate-release (exenatide IR, Byetta), a synthetic version of exendin-4 with C-terminal amidation to enhance its stability [ Figure 2 , Table 1 ], which became the first FDA-approved GLP-1RA in 2005 for the treatment of T2DM in adults [ Table 2 ]