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The primary concern is not a direct drug-nutrient interaction, but rather cumulative GI effects

First, rates are highest during dose escalation and usually improve with time on a steady dose

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As well as these broader systemic effects, it has also been suggested that DPP-4 may be able to modulate -cell function as part of a paracrine system involving GLP-1 produced locally within the pancreatic islets

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Injection site reactions: Mild redness or swelling at the injection site can occur regardless of dose