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The study, which used data from four Nordic countries, the US MarketScan Database and the Israeli Maccabi Health Services database, did not find a greater risk of major congenital malformations in infants after periconceptional use of GLP-1 receptor agonists and other second-line antidiabetic medications compared with insulin

Koeth RA, Wang Z, Levison BS, et al

Protein kinase C and protein kinase A are involved in the protection of recombinant human glucagon-like peptide-1 on glomeruli and tubules in diabetic rats

It's critical to separate correlation from causation here

The severity and duration follow similar patterns as well, with most nausea being mild to moderate and improving significantly after the first four to eight weeks of treatment

"Exception and Appeals Process Information." humana.com Eli Lilly