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Exendin-4, like GLP-1, stimulated dose dependently the glucose-induced insulin secretion in isolated rat islets, and, in mouse insulinoma beta TC-1 cells, both peptides stimulated the proinsulin gene expression at the level of transcription
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Of importance, aldolase-deficient cells covered the same area at the initial stages of spreading, suggesting that the observed increase in cell area is not a result of elevated cell volume or growth
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It isnt clear how the synergy arises, but additional research using the peptide may reveal novel pathways for improving cartilage growth, a notoriously challenging clinical problem
More serious but less common adverse effects include acute pancreatitis (seek urgent medical attention for severe, persistent abdominal pain), gallbladder disease, and risk of dehydration or acute kidney injury from prolonged vomiting Hypoglycaemia risk : When combined with insulin or sulfonylureas, GLP-1 receptor agonists increase the risk of hypoglycaemia [1] Long-term safety : The extended safety profile in older populations and those with established dementia requires further investigation Patients should report suspected side effects via the MHRA Yellow Card Scheme and discuss both the established benefits for metabolic health and the investigational nature of any cognitive effects with their healthcare provider
