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Eur J Clin Invest 25 : 176181

BM and MT conceived the study, helped to draft the manuscript, and coordinated the process

doi: 10.1530/EJE-14-0295 4 AdamskaAebkowskaAKrentowskaAHryniewickaJAdamskiMLeniewskaMet al

Adverse effects observed in trials to date include: Gastrointestinal symptoms nausea, vomiting, diarrhoea, and constipation (common with GLP-1 receptor agonists) Reduced appetite and weight loss , which may be excessive in some individuals Elevated heart rate , a concern noted with glucagon receptor agonism As with other incretin-based therapies, there is also a class-level signal for acute pancreatitis and gallbladder disease (including cholelithiasis and cholecystitis)