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Serious events in observational data: A 2023 JAMA analysis comparing GLP-1RA users to non-users reported higher relative rates of certain GI events (biliary disease, pancreatitis, bowel obstruction, etc)

Reduced incretin effect in Type 2 (non-insulin-dependent) diabetes

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There is no head-to-head trial, so better cannot be established from evidence

This suggests that a significant number of users do report elevated levels of distress