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[15] [13] Other notable adverse effects include: Hypoglycemia : Low risk when used as monotherapy, but increased when combined with insulin or sulfonylureas Injection site reactions : Erythema, pruritus, or discomfort in approximately 2% to 4% of patients Fatigue and dizziness : Reported in 5% to 8% of participants Increased heart rate : Mean increases of 2 to 4 beats per minute observed [1] [2] Serious adverse events were uncommon but included acute pancreatitis (approximately 0.2% incidence), gallbladder disease including cholecystitis and cholelithiasis (0.6% in diabetes trials and up to 2.5% in weight management trials, associated with rapid weight loss), and acute kidney injury, typically in the context of severe dehydration from gastrointestinal symptoms

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To compensate for their lack of oxygen, cells utilize hypoxic signaling mediated mainly by HIF1 (257)

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