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This severe metabolic inflexibility directly contributes to the debilitating phenomenon of post-exertional malaise (PEM), where patients experience a massive, multi-day crash in symptoms following minor physical or cognitive exertion, effectively trapping them in a cycle of energy debt

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Additionally, further study of the effect of these systemic medications on retinal cells, retinal metabolism and clinical behavior of DME is warranted

A thorough clinical assessment is essential to identify the underlying cause

Some individuals are highly sensitive to GLP 1 receptor activation and experience meaningful appetite regulation early in treatment