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Sometimes the answer is a higher dose

Indeed, the common hepatic branch, as well as celiac and gastric branches, have all been implicated in contributing to the glucoregulatory effects of gut GLP-1 62,125,126 , although selective knockdown of GLP-1R in nodose ganglia does not impair oral glucose tolerance or glucose-stimulated insulin secretion, similar to genetic knockout of GLP-1R in vagal neurons 127,128

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Even experienced patients may develop suboptimal injection habits over time

Nausea is the most common side effect, which generally subsides as a persons body adjusts to the medication