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The higher upfront cost purchases dramatically better efficacy and likely superior long term maintenance

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Patients should seek medical advice if they develop symptoms such as sustained pain in the upper right abdomen, fever, or jaundice Hypoglycaemia : Risk is increased when GLP-1 receptor agonists are used alongside insulin or sulfonylureas in patients with type 2 diabetes

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40,41 Metformin, by elevating levels of intracellular AMP levels, might block adenylate cyclase, which facilitates the conversion of ATP to cAMP, hence reducing intracellular cAMP levels and ultimately reducing the signalling of glucagon, leading to reduced glucose levels