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Mild nephrotoxicity may be difficult to detect because decreased kidney function does not always have outwardly obvious signs or symptoms

For those with established diabetes, adjustments to existing diabetes medications (such as metformin, sulfonylureas, or insulin) may be necessary

Daxer, A., Misof, K., Grabner, B., Ettl, A

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Additionally, there is potential for functional interaction between incretin receptors and other GPCRs, including the SCFA-activated FFARs, to occur in the islets of Langerhans (as previously discussed), but also in the gut and the hypothalamus, all of which could influence incretin therapy responses