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11 Place in Therapy In the ADA's 2018 Standards of Medical Care in Diabetes , DPP-4 inhibitors are indicated as an add-on option for patients without clinical atherosclerotic CV disease (ASCVD) who are unable to reach goal A1C after taking metformin for 3 months

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Alternatively, ethyl bromoacetoacetate can be used as the starting material

However, if extremely high doses are given for a long time, pyridoxine can cause nerve damage leading to numbness or tingling in the hands and feet (peripheral neuropathy)

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BPC-157 for Diabetic and Chronic Wounds Diabetic wounds and other chronic wounds pose significant clinical challenges