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GLP-1 agonists enhance insulin secretion from pancreatic beta cells only when blood glucose levels are elevated, a mechanism termed "glucose-dependent insulinotropic action." This physiological approach reduces the risk of hypoglycemia compared with sulfonylureas or exogenous insulin, though the risk increases when GLP-1 agents are combined with insulin or sulfonylureas, potentially requiring dose adjustments of these medications

Magnetic resonance imaging (MRI) further revealed a 4.7 cm cystic mass at the para-aortic region abutting to the 3rd and 4th portion of the duodenum (Figs

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American Academy of Neurology guidelines on treating painful DPN recommend that clinicians evaluate oral, topical and nonpharmacologic therapies for patients with painful diabetic polyneuropathy, and emphasizes switching between drug classes rather than trying multiple agents within the same class if one fails [63]