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It has recently been shown that GLP-1R neurons in the dorsomedial hypothalamic nucleus regulate pancreatic activity by affecting the dorsal motor nucleus of the vagus, specifically lowering blood glucose levels by increasing insulin release (Huang et al., 2022)

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2022;386(7):e17

Fasting insulin levels decreased by up to 71%, while hemoglobin A1c (HbA1c) reductions reached 2.2% in type 2 diabetes participants

So far, we do not have definitive evidence to show that taking GLP1 causes small intestinal bacterial overgrowth (SIBO)

Beyond the pancreas, GLP-1Rs are also present in the gastric mucosa of the human stomach (Broide et al., 2013) and within enteric neurons distributed throughout the intestine (Richards et al., 2014