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That came out of animal model studies, where they gave large amounts of these drugs, and the animal model would get what's called C cell hyperplasia

Exenatide, purified from the Gila monster Heloderma suspectum , has an increased binding affinity to the GLP-1 receptor (GLP-1R) and reduced rate of degradation by DPP-4 compared to GLP-1, increasing its half-life from 1 min to over 2 h ( Three classes of DPP-4 inhibitors (Gliptins) are in clinical use to augment the endogenous incretin effect, and these provide 80%90% efficacy in inhibiting the peptidase

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The greater impact on morbidity and mortality of diabetes in patients who develop the condition at a younger age compared to those who develop it later [77]