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Minimizing Risk of Infection Infectious diseases are more frequent and more serious in patients with diabetes mellitus due to the hyperglycemic environment that favors immune dysfunction (e.g., damage to the neutrophil function, depression of the antioxidant system, and humoral immunity), micro-and macro-angiopathies, neuropathy, decrease in the antibacterial activity of urine, gastrointestinal and urinary dysmotility, and the greater number of medical interventions in these patients

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Phentermine A prescription stimulant that suppresses appetite and slightly boosts metabolism Often used short-term, but studies support longer use in some low-risk patients Average weight loss: ~6% Side effects: dry mouth, jitteriness, insomnia, increased heart rate Not suitable for those with heart conditions or high blood pressure Orlistat (Alli, Xenical) Blocks absorption of about 30% of dietary fat Must be taken 3x daily with meals Average weight loss: ~35% over a year Side effects: oily stools, gas, urgent bowel movements Requires a multivitamin to replace lost fat-soluble vitamins (A, D, E, K) Qsymia Combines phentermine with topiramate (originally for seizures/migraines) Targets multiple pathways: appetite + cravings Average weight loss: ~910% Side effects: dry mouth, mood changes, tingling, insomnia Women of childbearing age need reliable contraception Contrave Combines bupropion (an antidepressant) with naltrexone (used for addiction) Helps reduce emotional eating and cravings Average weight loss: ~59% Side effects: nausea, insomnia, headache, dry mouth Not for use if you have seizures, are on opioids, or have certain mental health conditions The New Era: GLP-1s, Dual, and Triple Agonists More recently, medications that target gut and brain hormones have made significant waves in obesity care

Consistent with the high expression of peripherin in the trigeminal ganglia and the DRG (Extended Data Fig