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Employing preclinical, ex vivo, in vivo, and in vitro model systems investigators determined that GLP-1 agonists exert anti-inflammatory and immune modulating effects through their effects on macrophages (reduced interleukin [IL] 1β, IL-6, tumor necrosis factor [TNF]α, and C-X-C motif chemokine ligand [CXCL]), T and B lymphocytes (reduced cluster of differentiation [CD] 4 cells), monocytes (increased IL-10), mononuclear cells (decreased monocyte chemoattractant protein [MCP]−1, cell death protein [PD],, CD4 and CD8 T cells) [51–55]
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In people with type 2 diabetes who also use insulin or insulin-stimulating drugs, such as sulfonylureas, the risk of low blood sugar, also called hypoglycemia, may be increased, so the doses of those medicines may need to be lowered
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