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190 In general, cyanopyrrolidines such as saxagliptin are competitive inhibitors rather than noncompetitive inhibitors of DPP-IV enzymatic activity since they form reversible covalent bonds with serine residue 630 located within the enzyme's active site

Work through it in order before concluding the peptide isn't working

Given the vast number of incretin-based medications under development, mainly aiming at higher efficacy in body weight reduction, one may overlook that adherence to, and persistence of, therapy with GLP-1RAs in real-world studies is relatively low (18, 126)

Long-term use beyond the recommended period increases the risk of physical and psychological dependence