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Indeed, pancreatic nesidioblastosis (a hyperplasia of islet cells that is potentially driven by elevated secretion of GLP1) has been implicated in the pathogenesis of refractory hypoglycaemia

How Blue Shield Denies Access to Zepbound Blue Shield of California and the Zepbound Trap How shifting rules, opaque denials, and regulatory reversals are blocking patients from GLP-1 drugs By Vic Gerami As demand for GLP-1 weight-loss drugs like Zepbound surges nationwide, patients insured by Blue Shield of California say access often depends less on medical eligibility than on endurance