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However, the EMA advises against using liraglutide and semaglutide in individuals with a creatinine clearance below 30 mL/min, which corresponds to CKD stages 4 and 5 or kidney failure

Each dose escalation restarts the four-to-five-week steady-state clock, which is why the full therapeutic effect takes several months to emerge

Suspected Gastroparesis With Concurrent Gastroesophageal Reflux Disease Induced by Low-Dose Liraglutide, July 2022, Ishihara et al

This research theorized that hyperglycemia can lead to a downregulation of GIPr causing decreased GIP response despite therapeutic or even supratherapeutic levels of GIP [21]