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Their rapid rise in use and cost highlights both their clinical promise and the strain they place on healthcare systems

IR induced metabolic disturbances lead to degradation of brain function, and prolonged uncontrolled high blood glucose levels adversely affect a variety of metabolic pathways such as oxidative stress, formation of advanced glycosylation end products (AGEs), and protein kinase C activation, while metabolic disturbances inducing cerebral microvascular damage affect the extent of cognitive impairment (1, 7)

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When that effect weakens, you notice it in specific ways

New or worsening depression should be addressed, as fatigue is a common symptom of mood disorders

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