Table 4

Side effects of GLP-1 based therapies

Frequency
Side effectGLP-1RADPP-4IPotential mechanism
GI
 Nausea+++++Gastric emptying ↓, activation nausea centres
 Vomiting+++Gastric emptying ↓, activation nausea centres
 Diarrhoea++++Unknown
 Constipation+++Intestinal motility ↓
 Flatulence+++Unknown
 Gastric reflux+++/++Unknown
 Pancreatitis+/−+/−Unknown
 Cholelithiasis+/−?Weight loss, bile acid production ↓, gallbladder motility ↓
Other
 Hypoglycaemia*+/+++/++Insulin secretion ↑, intestinal glucose uptake ↓
 Nasopharyngitis++Unknown
 Anaphylaxis+/−+/−Immunoreactive
 Prerenal failure+/−+/−Dehydration by vomiting, diuresis ↑

  • Based on the summary product characteristics of all registered GLP-1RA and DPP-4I.

  • *Predominantly observed in combination with sulfonylurea agents, not with metformin.

  • +++, very common (>1/10); ++, common (>1/100); +, uncommon (>1/1000); +/−, rare to very rare (>1/10 000); −, not present; ?, unknown.

  • DPP-4I, dipeptidyl peptidase 4 inhibitor; GLP-1RA, glucagon-like peptide-1 receptor agonist.