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Beyond its well-characterized GH secretagogue activity, Hexarelin has been studied extensively for direct cardioprotective effects through a GH-independent mechanism with research demonstrating binding to the CD36 scavenger receptor in cardiac tissue and cardioprotective effects in ischemia-reperfusion models, myocardial infarction paradigms, and heart failure models independent of pituitary GH release, establishing it as a unique dual-mechanism research compound spanning neuroendocrine and cardiac biology

While this effect is beneficial for controlling diabetes, it may occasionally lead to hypoglycemia, particularly in the context of concomitant use with other antidiabetic medications or insulin

Randomized clinical trial comparing the efficacy and safety of treatment with the once-weekly dipeptidyl peptidase-4 (DPP-4) inhibitor omarigliptin or the once-daily DPP-4 inhibitor sitagliptin in patients with type 2 diabetes inadequately controlled on metformin monotherapy