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The reduction of cardiovascular events is not only related to anti-diabetic properties, but also to pleotropic effects leading to the reduction of the residual cardiovascular risk, that has been defined as the risk of progression of CV events (MACE or HF) that remains after the optimal glycaemic control in T2DM patients, and it seems to be related to meta-inflammation, defined as a low-grade chronic and sterile inflammatory status

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Gastrointestinal symptoms decrease markedly after the dose escalation phase, and long-term tolerability is favourable for most patients

While the results were encouraging, by the mid-1990s Holst and Carolyn Deacon, a physiologist at the University of Copenhagen, confirmed an earlier finding by Rolf Mentlein, Baptist Galllwitz and Wolfgang Schmidt based at the University of Kiel in Germany who had found in 1993 that GLP-1 did not last long in the body because it was broken down in minutes by dipeptidyl peptidase-IV (DPP-4), an enzyme found in numerous tissues and in the bloodstream (Mentlein, Galllwitz, Schmidt