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Diabetic patients must follow a regular, prescribed diet and exercise schedule to avoid either hypo- or hyperglycemia. Fever, thyroid disease, infection, recent trauma or surgery, diarrhea secondary to malabsorption, vomiting, and certain medications can affect requirements of antidiabetic agents; dosage adjustments may be necessary. Diabetic patients should be given a 'sick-day' plan to take appropriate action with blood glucose monitoring and their antidiabetic therapy, including liraglutide, when acute illness is present. Temporary use of insulin in place of oral antidiabetic agents may be necessary during periods of physiologic stress (., burns, systemic infection, trauma, surgery, or fever).

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Caspase-3 activity assay.  An assay of caspase-3 was performed according to caspase-3 kit’s instruction (Sigma). Lysis Buffer (250 mM HEPES, pH , 25 mM CHAPS, 25 mM DTT) was added to the testes tissue samples and lysates were incubated at 37°C with Ac-DEVD-pNA, colorimetric substrate (DEVD-AFC; Biomol, Plymouth Meeting, PA, USA) preferentially cleaved by caspase-3. The amounts of pnitroanilide were monitored continuously over 5 hr with a plate reader (Anthos2020) and absorption was measured at 405 nm, normalized to the absorbance of control cells and expressed as per cent of control established from 10 animals. Absorbance of blanks, determined as no-enzyme control and no-substrate control, was subtracted from each value.

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