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Very common side effects (affecting more than 1 in 10 people) include: Nausea, vomiting, and diarrhoea (usually temporary) Reduced appetite Common side effects (affecting up to 1 in 10 people) include: Constipation Abdominal pain or discomfort Headache Injection site reactions Fatigue Contact your GP promptly if you experience: Persistent or severe abdominal pain , particularly if radiating to the backthis may indicate pancreatitis Persistent vomiting that prevents adequate fluid intake Signs of dehydration : reduced urination, dizziness, dry mouth Symptoms of hypoglycaemia (if taking alongside insulin or sulphonylureas): trembling, sweating, confusion, rapid heartbeat Visual changes or eye pain, especially if you have diabetic retinopathy Unexplained weight loss exceeding expected therapeutic effect Mood changes or thoughts of self-harm Right upper abdominal pain, yellowing of skin/eyes, or dark urine which may indicate gallbladder problems Seek immediate medical attention (call 999 or attend A&E) if you develop: Severe, persistent abdominal pain with vomiting Signs of severe allergic reaction: difficulty breathing, facial swelling, severe rash Symptoms of diabetic ketoacidosis (particularly if insulin doses have been reduced): excessive thirst, frequent urination, confusion, fruity breath odour Severe hypoglycaemia with loss of consciousness Important safety information: GLP-1 medications are not recommended during pregnancy or breastfeeding

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The shielding action of GLP-1 also involves the activation of the phosphoinositide 3-kinase (PI3K) and extracellular signal-regulated kinase (ERK) pathways and the upregulation of PDX-1 transcription (36)

Fertil Steril, 2017

Statistical Analysis for Preclinical Studies The software Stata, version 18 (StataCorp LLC), was used to perform the meta-analysis

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