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Although the risk of hypoglycemia is very low due to its glucose-dependent mechanism of action, the risk of hypoglycemia may increase when used in combination with medications that can cause hypoglycemia

Yakunin et al

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These changes encompass the 2nd, 8th, 15th, and 27th amino acids, and such adjustments might arguably extend the peptide's lifespan against enzymatic breakdown, particularly by enzymes like dipeptidyl peptidase-4 (DPP-4)