Regarding the GLP1-ra pharmacodynamics, a hypothesised mechanism through which GLP1-ra predisposes to diabetic retinopathy is via rapid reduction in HbA1c which can lead to alterations in VEGF and IGF-1 that can lead to the development or early worsening of diabetic retinopathy [41, 42]. The gene discussed is IGF1; the disease is diabetic retinopathy.