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Risks include nausea intensification during fasting, dehydration from reduced fluid intake during non-eating periods, and low blood sugar if you're also taking diabetes medications

Gradual titration of the SYMLIN dose minimizes the incidence and severity of nausea [see Dosage and Administration (2)]

However, in infants born to people with type 2 diabetes who took a second-line noninsulin antidiabetic medication including GLP-1 receptor agonists the study did not find a greater major congenital malformation risk compared to infants exposed to insulin