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A single missed dose that is taken within 2 days rarely derails progress, but repeated delays can weaken the medication's appetite-suppressing effect and slow weight loss results

"If the itchiness is due to a mild allergy, an antihistamine may provide relief," Ali says

Exendin-4 upregulates adiponectin level in adipocytes via Sirt1/Foxo-1 signaling pathway

Its mechanism targets appetite regulation and gastric motility rather than direct insulinotropic effects

You should contact your GP or diabetes specialist nurse if you experience: Significant skin changes that cause distress or affect your quality of life, as this may impact treatment adherence Skin breakdown, ulceration, or persistent redness in areas of loose skin, which could indicate infection or other complications Consistent weight loss exceeding 1 kg per week for several weeks, which may require dose adjustment or additional nutritional support Signs of nutritional deficiency , such as brittle nails, hair loss, or unusual fatigue, which may accompany inadequate dietary intake Concerns about injection site reactions , including lumps, persistent bruising, or changes in skin texture at injection sites Seek urgent medical attention if you develop: Severe, persistent abdominal pain (possibly radiating to the back), which could indicate pancreatitis Yellowing of the skin/eyes, fever or severe abdominal pain, which might suggest gallbladder problems Persistent vomiting or signs of dehydration Sudden visual changes, especially if you have pre-existing diabetic retinopathy Symptoms of low blood sugar (hypoglycaemia) if you also take insulin or sulfonylureas Your healthcare provider can assess whether your weight loss is occurring at an appropriate rate and ensure you are receiving adequate nutritional support