The intensive treatment of the multiple risk factors reduces the development/progression of renal disease18 which is why guidelines insist on comprehensive management of the patient with diabetes (glycemic control and control of cardiovascular risk factors, use of renin-angiotensin system inhibitors, as well as lifestyle changes, including smoking cessation or weight loss in overweight/obese individuals, among others).19 However, the residual renal risk remains very high in optimally treated patients.20 More recently, iSGLT2 has been shown to reduce the risk of cardiovascular and renal events, but still, the residual risk of renal disease progression remains high.21,22 Nevertheless, although the rate of diabetes-related complications (such as myocardial infarction, stroke, lower limb amputations or mortality) have decreased significantly in recent decades, this is not the same for CKD patients requiring renal replacement therapy attributed to diabetic kidney disease (DKD).23 Therefore new treatments are needed that improve glycemic control independently of GFR, with a low risk of hypoglycemia and able to reduce cardiovascular and renal risk in this population
Several mechanisms may contribute to hair thinning during weight loss treatment: Nutritional deficiencies : Rapid weight loss may result in inadequate intake of protein, iron, zinc, and essential fatty acidsall crucial for healthy hair growth Metabolic stress : Significant shifts in energy balance and hormonal regulation can disrupt the hair growth cycle Reduced caloric intake : Severe energy restriction may divert bodily resources away from non-essential functions like hair growth Protein malnutrition : Insufficient protein intake affects keratin production, the structural protein of hair It is important to note that telogen effluvium is typically self-limiting and reversible
The essential element in the physical examination is the localization of swelling and tenderness in the Achilles tendon in the critical zone or at the insertion
E.BastinJ
It is unknown whether OZEMPIC causes thyroid C-cell tumors, including medullary thyroid carcinoma (MTC), in humans as the human relevance of semaglutide-induced rodent thyroid C-cell tumors has not been determined (5.1, 13.1)
