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Any cellular or metabolic stress that reduces ATP production (e.g., heat shock, hypoxia, ischemia, glucose deprivation) or accelerates ATP consumption (e.g., contraction of skeletal muscle) will increase the ADP/ATP ratio, which will be amplified by the action of adenylate kinase, resulting in increased AMP/ATP with the consequent activation of AMPK (Figure 3)

Renal glucose excretion as a function of blood glucose concentration in subjects with type 2 diabetes results of a hyperglycaemic glucose clamp study

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While some individuals may notice subtle improvements in appetite, sleep, or energy shortly after starting treatment, most benefits develop gradually over time as the body responds to the peptides signaling effects