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Testing revealed cholinergic insufficiency and low BDNF expression

Pregabalin is currently considered the first-line treatment for painful DPN in most guidelines [120]

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They create inflammation in the lip tissue, and inflammation is exactly what triggers melanin overproduction in the first place

After excluding occasionality, we hypothesized that this may be due to the excitability of SNS by GLP-1RA, especially exenatide, in line with the findings of multiple preclinical studies that showed that Exendin may acutely activate SNS, and this effect independent of insulinotropic and hypothalamus-pituitary-adrenal axis activation can be blocked by GLP-1 antagonist