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In addition, because the studies participants had severe hyperglycaemia, metformins glucose-lowering effect may have also been related to changes in peripheral insulin sensitivity, but this was not measured in those studies
It's worth noting that increased heart rate is a recognised class effect of GLP-1 receptor agonists, which some individuals may perceive as anxiety or palpitations
Contraindications include known hypersensitivity to any component of the injection (including cobalt hypersensitivity), a history of severe reactions to thiamine/pyridoxine/cobalamin injections, and Lebers hereditary optic neuropathy (for B12-containing products)
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