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Side effects are one contributing factor with respect to discontinuation

Clinical Recommendations to Manage Gastrointestinal Adverse Events in Patients Treated with Glp-1 Receptor Agonists: A Multidisciplinary Expert Consensus. Journal of clinical medicine vol

This means these formulations do not undergo the same rigorous testing for safety, efficacy, and quality that brand-name medications like Ozempic or Wegovy require

Besides its catalytic activity, DPP4 also acts as a binding protein and a ligand of extracellular factors and a large number of molecules can be cleaved by DPP4

PLoS ONE 9(6):e101005 De Marinis YZ, Salehi A, Ward CE, Zhang Q, Abdulkader F, Bengtsson M et al (2010) GLP-1 inhibits and adrenaline stimulates glucagon release by differential modulation of N- and L-type Ca2+ channel-dependent exocytosis