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178,180 The PI3K/Akt signaling pathway, activated by GLP-1, plays a vital role in maintaining pancreatic -cell survival and promoting their proliferation

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Other notable adverse effects include: Injection site reactions such as erythema, pruritus, or swelling Fatigue reported in approximately 5% to 6% of patients Hypoglycemia when used in combination with insulin or sulfonylureas Increased heart rate with modest elevations of 2 to 4 beats per minute (a class effect of incretin therapies with uncertain clinical significance) Serious but rare adverse effects include acute pancreatitis, gallbladder disease (cholelithiasis, cholecystitis), acute kidney injury (typically secondary to dehydration from gastrointestinal symptoms), and hypersensitivity reactions