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As per Bradford Hills criteria 41 , the biological plausibility through GLP-1R expression in the nervous system and temporal consistency in time-to-onset analysis support potential causality, but confounding factors inherent to spontaneous reporting systems preclude definitive conclusions

Adverse effects of GLP-1 receptor agonists such as dulaglutide include gastrointestinal disturbance and injection site reactions Sodium-glucose co-transporter 2 (SGLT-2) inhibitors and glucagon-like peptide-1 (GLP-1) receptor agonists have been recommended internationally in type 2 diabetes management guidelines for some time, but, until now, have been inaccessible to most people in New Zealand due to cost

Sowa emphasizes as critical for long-term success

Crumm, S., Cofan, M., Juskeviciute, E