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India has over 77 million adults with diabetes as of 2025
Gastroenterology 141:150156 Gier B, Matveyenko AV, Kirakossian D, Dawson D, Dry SM, Butler PC (2012) Chronic GLP-1 receptor activation by exendin-4 induces expansion of pancreatic duct glands in rats and accelerates formation of dysplastic lesions and chronic pancreatitis in the Kras(G12D) mouse model
When choosing among them, factors such as glycemic efficacy, weight effects and patient preferences may take precedence over concerns about major differences in [GI] risk. She added clinicians should continue to monitor for GI symptoms, particularly early in treatment, as these events, while uncommon, remain more frequent than with some other diabetes drug classes. According to Alkabbani and colleagues, recent trials revealed that dulaglutide (Trulicity, Eli Lilly), semaglutide (Ozempic/Wegovy, Novo Nordisk) and tirzepatide (Zepbound, Eli Lilly) increased the risk for mild to serious GI adverse events like pancreatitis, constipation, nausea, vomiting and biliary disease
Ismaiel A, Scarlata GGM, Boitos I, Leucuta DC, Popa SL, Al Srouji N, et al
Some compounding pharmacies and clinics use slightly different escalation schedules
