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Pooled trial data indicates the following side effects and their incidences [20]: Injection site reactions 24.5% Joint pain 13.3% Peripheral edema and limb pain 6.1% Muscle pain 5.5% Tingling sensations 4.8% Worsened glycemic control (elevated glycated hemoglobin) 4.5% Hypersensitivity (allergic reactions such as skin rash) 3.6% Carpal tunnel syndrome 1.5% Injection site reactions were the most common adverse reaction and mainly included pain, redness, and itchiness

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The mechanism involves upregulation of matrix metalloproteinases (MMPs) and their inhibitors, which remodel collagen in a more organized way than unassisted healing

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