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Science says that yes, they can

Patients should monitor for: Unexpected blood glucose elevations without clear cause (dietary changes, illness, new medications) Recurrence of diabetes symptoms such as increased thirst, urination, or fatigue Persistent high blood glucose readings (300 mg/dL) or symptoms of diabetic ketoacidosis (nausea, vomiting, abdominal pain, fruity breath) Severe abdominal pain (possible pancreatitis) These clinical changes have multiple potential causes beyond medication potency loss

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The retrospective, observational nature of our study and the use of prescription data must be acknowledged as limitations because they meant that some relevant factors could not be captured and accounted for in our analyses