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Conclusion Both the central circadian clock system and the control center of the GH/IGF-1 axis are located in the hypothalamus and related genes/hormones are expressed/released in circadian rhythm, which regulate metabolism through multi-level interactions

Methods: A comprehensive search was conducted across PubMed, Scopus, and Embase up to July 2024

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Neurologic symptoms of pellagra include headache, fatigue, apathy, depression, ataxia, poor concentration, delusions, and hallucinations, which can lead to confusion, memory loss, psychosis, and eventual death (27)

Practice nurses and diabetes specialist nurses typically provide initial training, covering proper technique, site rotation for injections (abdomen, thigh, or upper arm), and safe disposal of sharps

Medication Side Effects and Nutritional Deficiencies Certain medications, including some blood pressure drugs and cholesterol-lowering agents, can cause muscle pain or fatigue