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Lancet Diabetes Endocrinol (2017) 5(5):34154

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The reduced incretin effect of GIP in diabetic subjects may be due to the down-regulation of GIP receptor expression, which has been found in pancreatic islets of diabetic Zucker rats and reverted following correction of hyperglycemia [35]

Like all medications, GLP-1 agonists have side effects, including nausea, vomiting, diarrhea, and constipation, especially when first starting the medications or if the dose is increased