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After a recent tirzepatide dose escalation, the patient developed severe vomiting, metabolic derangements, sepsis physiology, and later GI bleeding, requiring coordinated management by endocrinology, gastroenterology, and cardiology.As GLP-1 use expands, careful dose titration, awareness of overlapping syndromes, and early multidisciplinary involvement are essential

Vitamin D and inflammatory diseases

New or worsening nephropathy, defined as persistent macroalbuminuria, persistent doubling of the serum creatinine level, and a creatinine clearance of 30 ml/min/1.73 m 2 should receive metformin and SGLT2i (Fig

Previous studies have reported a swift increase of H 2 O 2 production after insulin treatment [552,553,554] in liver cells and Carnesecchi et al