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Exenatide As the first GLP-1R agonist approved for T2DM, EX is a new class of compound and a synthetic product of exendin-4, which is a compound naturally derived from the Gila monster and has multiple hypoglycemic mechanisms: inhibiting of glucagon release from α cells, slowing of gastric emptying, decreasing appetite and increasing glucose-dependent insulin secretion (12, 46, 47)