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As for the DUAL-1 study, the primary endpoint was to prove non-inferiority of the combination compared to glargine and superiority compared to lixisenatide

However, while still requiring fewer conserved nodes in the base of the bundle than GLP-1, relative to oxyntomodulin more conserved nodes are used by exendin-P5 below the peptide-binding pocket to enable transmission of signalling to the G protein-binding site

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Additionally, patients with a history of diabetic retinopathy should be monitored for worsening retinopathy, particularly with rapid improvement in glucose control