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When the hormone GLP-1 finds a pancreatic beta cell, the ensuing chain of signals, proteins and gene expression changes that lead to insulin secretion is very well documented

Evidence for a decreased sensitivity of carnitine palmitoyltransferase I to malonyl-CoA inhibition after glucagon or cyclic AMP treatment

Rarer but more serious risks include pancreatitis, thyroid tumors, kidney issues, and even ileus a complete shutdown of the digestive tract requiring surgery