INS and Hypoglycemia: What should not be forgotten is that other factors can modify the response to GLP-1 RAs, such as associated medications/diseases, altered microbiota, genetic and socio-familial background, adherence/motivation to lifestyle changes or fear of hypoglycemia (higher in people treated with insulin or sulfonylurea, but not mandatory), and possible occurrence of GLP-1 RAs adverse effects which would rend the patient to improperly administer the medication.