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Less common but serious side effects include pancreatitis, gallbladder issues, and (in rare cases) thyroid tumors in patients with a personal or family history of medullary thyroid cancer or MEN-2

This phenomenon, known as "early worsening," is thought to result from rapid reduction in blood glucose levels rather than a direct drug effect

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A high glucose level did not increase the cAMP levels stimulated by 100-M DCA or 10-mM L-glutamine, suggesting that high glucose potentiates Gs activation-stimulated GLP-1, but not via cAMP in GLUTag cells (Fig