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Additionally, liraglutide is linked to the highest rate of severe gastrointestinal side effects (23.31%), while dulaglutide has the lowest (12.29%)

The relationship between diabetes and cognitive impairment involves many aspects, including central insulin signal transduction, nerve fiber damage caused by hyperglycemia, neuritis, oxidative stress, bloodbrain barrier damage, vascular neuropathy, changes in the dopaminergic system, and the effects of advanced glycation end products on metabolism and energy (Figure 1)

Still, as the authors themselves note, causality cannot be established from this type of dataset

Cardiovascular and metabolic effects of 48-h glucagon-like peptide-1 infusion in compensated chronic patients with heart failure

To overcome these limitations, a number of pharmacological approaches have been developed over the past decades, but these drugs are generally of fairly limited efficacy, expensive and can in some cases cause significant side effects

Clinical inertia in people with type 2 diabetes: a retrospective cohort study of more than 80,000 people