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Activation of the glucagon-like peptide-1 receptor (GLP-1R) potentiates the exchange protein directly activated by cyclic adenosine monophosphate/phosphoinositide 3-kinase/protein kinase B (Epac/PI3K/Akt), cyclic adenosine monophosphate/protein kinase A (cAMP/PKA), and adenosine monophosphate-activated protein kinase/sirtuin 1 (AMPK/SIRT1) pathways, which enhance mitochondrial function, autophagy, and metabolic reprogramming

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Ding F, Li HH, Zhang S et al : SnoRNA Snord116 (Pwcr1/MBII-85) deletion causes growth deficiency and hyperphagia in mice

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[21] [3] Hepatic impairment is also relevant: vildagliptin, for example, should be avoided in patients with hepatic impairment, and liver function tests (LFTs) should be monitored during treatment as specified in its SmPC