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GLP-1 medications solve this by using modified versions of the hormone that resist enzymatic breakdown, maintaining elevated levels for days or even a full week depending on the formulation

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(PubMed) Xue YZ, Wang LX, Liu HZ, Qi XW, Wang XH, Ren HZ

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Heart failure can occur if you are taking insulin together with pills called TZDs (thiazolidinediones), even if you have never had heart failure or other heart problems

The rate of discontinuation due to adverse events varied from 5% to 19%, predominantly due to gastrointestinal side effects [17]