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In normal conditions, melatonin promotes autophagy for regulating cell survival, but during hyperglycemia and oxidative stress, melatonin indirectly inhibits autophagy through alleviating oxidative stress, inflammation, and endoplasmic reticulum stress and decreasing proinflammatory cytokines and VEGF [41-42]

Previous studies in macrophages have implicated extracellular ATP (eATP) and P2X 7 R signalling in exosome biogenesis through activation of neutral sphingomyelinase (nSMase), an enzyme negatively regulated by intracellular glutathione (iGSH) [7,2]

While this improves how cells use glucose and fats, it doesnt directly change appetite signals or gastric emptying the way GLP-1 medications do