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The main enzyme involved, dipeptidyl peptidase-4 (DPP-4) also known as CD26, cleaves off the two N-terminal residues resulting in GLP-1 (9-36 amide) which is inactive or acts as an inhibitor at the GLP-1 receptor (23)
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Of those 15 cases, 12 were found to be possibly linked to use of GLP-1 RAs, while 3 could not be assessed due to missing clinical information
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