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Peptides play an important role in metabolic functions. As a consequence, their cognate receptors have emerged as important therapeutic targets to treat diseases such as hyperglycemia, hypoglycemia, irritable bowel disease and obesity. Natural peptides tend to have very short half-lives. In recent years several new chemical modifications have been introduced to improve the in vivo half-life of peptides. These include placement of bulky amino acids around metabolic clip sites, lipidation to increase plasma protein binding, incorporation of β-amino acids and introduction of conformational constraints. This chapter details the optimization of metabolic peptides using these underlying principles to improve stability and in vivo efficacy, resulting in approved and widely accepted therapies.

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