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Assessing autonomic dysfunction in early diabetic neuropathy: the Survey of Autonomic Symptoms

Key Points Individuals with GSTM1 -positive and GSTT1 -positive genotypes are at increased risk for renal cell carcinoma (RCC) when occupationally exposed to certain toxicants Individuals with the GSTM1 -null genotype are at increased risk for bladder cancer, which might be potentiated by smoking and occupational hazards Data on the influence of GSTT1 polymorphism on the risk for transitional cell carcinoma (TCC) are inconsistent In the process of kidney cancerization, expression of GSTA isoenzymes is downregulated, which contributes to decreased antioxidant capacity in RCC and might enhance RCC growth In the malignant phenotype of TCC of the urinary bladder, upregulation of GSTT1 and GSTP1 might provide a reduced cellular environment and inhibit apoptotic pathways, respectively

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Understanding how to safely resume treatment and minimize clinical impact is essential for patients relying on tirzepatide for diabetes management or chronic weight control

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