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Studies were assessed for quality using criteria appropriate to their study design, such as the Cochrane Collaboration's risk of bias tool for RCTs or the Newcastle-Ottawa Scale for observational studies

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Within seconds of the sensing of increased reactive oxygen species (ROS), several enzymes of glycolysis (particularly glyceraldehyde-3-phosphate dehydrogenase and pyruvate kinase) are inhibiting allowing for the diversion of glucose carbons into the PPP

The exact biological mechanism by which GLP-1 receptor agonists and dual GIP/GLP-1 receptor agonists like tirzepatide might induce dysesthesia or allodynia is not fully understood

References Torre E, Vetrano S, Vertu S, Zazzaron M, Russo R