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Insulin gene expression is upregulated in pancreatic -cells after GLP-1R activation, which increases insulin mRNA expression through activation of transcription factors such as pancreatic and duodenal homeobox-1 and cAMP-response element binding protein (Table 1), contributing to an increase in -cell numbers (Tengholm and Gylfe, 2017

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Fatigue: Some users report feeling more "wiped out" the day after a dose if the timing is shifted