Therefore, taking into consideration the DPP4 mechanism of action, its pharmacological inhibition by gliptines will avoid interaction with its substrates, increasing plasmatic GIP and GLP-1 concentrations and stimulating insulin biosynthesis [39]
Int J Pharm 435 , 39, doi:10.1016/j.ijpharm.2012.06.005 (2012)
however, these studies frequently lack methodological rigor, appropriate controls, and adequate statistical power to confirm efficacy
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This means tongue darkening in Addison's disease is typically diffuse rather than focal, and it is almost always accompanied by other signs: darkening of skin creases, knuckles, scars, and other mucosal surfaces, along with systemic symptoms like fatigue, weight loss, low blood pressure, and salt cravings