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Evidence shows that the secretion of incretin hormones may be impaired in some patients (particularly secretion of GLP-1 in obese individuals), but the major responsible factor is a loss of beta cell responsiveness to the incretin hormones [4]

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Notably, among patients with an ALT more than 2-times the upper limit of normal, levels improved by 46.8 U/L ( P = .01)

It is why patients with a personal or family history of medullary thyroid carcinoma, or Multiple Endocrine Neoplasia syndrome type 2, are excluded from GLP-1 treatment