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This can happen if the diluent was sprayed directly onto the powder or if the vial was shaken

Diabetologia 29:4654 Knop FK, Vilsbll T, Hjberg PV et al (2007) Reduced incretin effect in type 2 diabetes: cause or consequence of the diabetic state

Further, a meta-analysis of 18 randomized controlled trials (RCTs) with 1,580 T2D patients reported that liraglutide also improves indicators of renal function such as urine albumin-creatinine ratio, serum creatinine, cystatin C, and several inflammatory markers [16]

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Missing a dose or injecting too late can lead to dips in effectiveness, stronger side effects, or confusing hunger signals

[1] [3] If left untreated, some of these changes can become permanent