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A., Duran S., Kim D., et al., A Comparison of TwiceDaily Exenatide and Biphasic Insulin Aspart in Patients With Type 2 Diabetes Who Were Suboptimally Controlled With Sulfonylurea and Metformin: A NonInferiority Study, Diabetologia 50 (2007): 259267

They should typically be avoided in individuals who: Have a personal or family history of medullary thyroid cancer Have multiple endocrine neoplasia syndrome type 2 (MEN2) Have a history of pancreatitis Are pregnant or breastfeeding Have severe gastrointestinal disease such as gastroparesis This is why a thorough medical evaluation is essential before starting treatment

Cureus 12 (8), e10128

However, the medication's gastrointestinal effectsparticularly nausea, vomiting, and diarrheacan lead to dehydration and prerenal acute kidney injury if fluid intake is inadequate

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