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The most commonly reported flu-like manifestations include: Nausea and general malaise the most frequent side effect, with incidence varying by product and dose (ranging from approximately 15-40% depending on the specific medication and dosage) Fatigue and low energy levels often described as feeling generally unwell or 'run down' Headaches ranging from mild to moderate intensity Dizziness or light-headedness particularly when standing up quickly, which may reflect dehydration or, in patients also taking insulin or sulfonylureas, possible hypoglycaemia Loss of appetite which, whilst therapeutically beneficial, can contribute to feeling unwell Mild gastrointestinal upset including occasional vomiting or abdominal discomfort These symptoms typically emerge because GLP-1 medications significantly alter gastrointestinal function and metabolic processes

A retrospective cohort study based on administrative claims data of 32,800 exenatide patients who were propensity score matched to patients treated with MET or glyburide found no increased risk for either benign thyroid neoplasms (RR 0.7

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GLP-1RAs ameliorate ROS-induced or hyperglycemia-induced apoptosis through modulating IL-6 production and ER stress-induced by hyperhomocysteinemia, via stromal cell-derived factor (SDF)-1/C-X-C motif receptor 7 (CXCR7) -AMPK/p38-MAPK axis [113-115]