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Given the rapid degradation of intestinally secreted GLP-1 by DPP-4, there are suggestions that these GLP-1 receptors are activated locallyi.e., by gastric-produced GLP-1

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It should be avoided or used only under clinician supervision in patients with kidney disease, older adults, or those at risk for electrolyte abnormalities , due to the risk of hypermagnesemia., Use sparingly: Stimulant laxatives (such as bisacodyl or senna) may be effective for intermittent rescue use , but they can cause cramping and are generally not needed for routine long-term management when osmotic agents are effective., Safety note: Regular stimulant laxative use that causes frequent loose stools may contribute to dehydration and electrolyte imbalance (including hypokalemia) and should therefore be intermittent unless clinician-directed . What about docusate (Colace)

Gastroenterologists generally prefer Miralax for GLP-1 users

In contrast, magnesium glycinate is a form that is highly absorbable and less likely to have a laxative effect, making it better for correcting a magnesium deficiency without causing digestive upset