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Panelists agreed that the overestimation of patients refusal of injectable drugs limits the early use of GLP-1 RAs, which are recommended before insulin initiation as the first injectable therapy [6, 8]

doi: 10.2174/0118715206342278241008081126 206 ZhaoHAoLSorinaWeiYYinHZZhangNet al
This dual-action mechanism may influence appetite control and metabolic response differently

It could be a direct effect on your hearts receptors, or a reaction to low blood sugar, dehydration, or the stress of starting a new injection

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