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This, in turn, stimulates downstream signaling elements dependent on both protein kinase A (PKA) and exchange protein directly activated by cAMP (EPAC) activation, which triggers the opening of voltage-dependent calcium channels (VDCCs), resulting in insulin exocytosis [24, 25]

[DOI] [PubMed] [Google Scholar] 65.Sherman M.M., Ungureanu S., Rey J.A

These include persistent abdominal pain, vomiting that contains blood or material resembling coffee grounds, severe dizziness, shortness of breath, or signs of allergic reaction such as facial swelling or hives

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However, digestive enzymes do not speed up stomach emptying, which is the underlying issue in gastroparesis

The big caveat is that these trials followed people for a few years at most