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However, in patients with HbA1c 7%, GLP-1RA use was associated with a higher risk of composite outcomes and herpes simplex infection compared with DPP-4i (HR:1.125, 95% CI: 1.0221.238) and (HR:1.269, 95% CI:1.0781.493)

Metformin is well-established as reducing B12 absorption , primarily through interference with calcium-dependent B12-intrinsic factor uptake in the terminal ileum

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The activation of iNKT cells increases the expression of pro-inflammatory cytokines such as IFN-, TNF-, and IL-17, which can intensify the severity of skin lesions [56,57]

References [1] Liu J, Wang Y, Zhang X, et al