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NAC has its own robust clinical evidence base, particularly for respiratory and liver health, and is generally well absorbed orally
Circulating plasma DPP-4 levels are shown to have a strong correlation with plasma DPP-4 enzymatic activity (21)
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However, despite these interventions, clinical outcomes remain suboptimal: approximately 30%40% of diabetic foot ulcers fail to heal within 20 weeks of standard care, and the 5-year mortality rate following amputation exceeds 70% ( The impairment of DW healing is a multifactorial, multi-stage pathological process involving hyperglycemia, accumulation of advanced glycation end products (AGEs), oxidative stress, persistent inflammation, impaired angiogenesis, neuropathy, and increased infection risk (Peng et al., 2023) (Table 1)
This is the same biological mechanism that causes general dark lips after inflammation, but concentrated in a single spot rather than spread across the lip surface
