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Alterations in key metabolic pathways such as glycolysis and oxidative phosphorylation profoundly affect the activation, differentiation and function of B and T cells, monocytes, neutrophils and other immune cells, driving inflammation and tissue injury

Over the years, cardiovascular protection trials have prompted editorials and even guideline recommendations to choose, whenever possible, diabetic drugs with evidence of CV benefit and to avoid sulfonylureas in patients with established ASCVD

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These include nausea, vomiting, bloating, diarrhea, and constipation, often linked to how these drugs slow digestion and alter intestinal movement

Such patients may well be candidates for laxative abuse, a fact often denied or concealed by patients