The five qualifying conditions The five qualifying conditions for the NHS pathway under NICE TA1026 are 4 : Type 2 diabetes High blood pressure (hypertension) Cardiovascular disease (previous heart attack, stroke, angina, or coronary procedure) High cholesterol or dyslipidaemia Obstructive sleep apnoea For the private route, the Mounjaro and Wegovy product licences accept any one of these, plus prediabetes (an HbA1c blood-sugar reading between 42 and 47 mmol/mol) 1,2
However, due to (i) rareness of the disease (unfamiliar to most neurologists), (ii) non-inclusion of GNE genetic testing for neurological indications, and (iii) non-specific symptoms at disease onset (foot-drop, balance impairment), the diagnosis of these patients is difficult and often delayed
It was thought that injury to the epithelium, which mainly impacts goblet cells, produced inflammation (Jang et al
In a separate randomized controlled trial from India, Sakpal and others (Sakpal et al., 2017) evaluated VD supplementation in 81 patients with NAFLD and VD deficiency, finding that a single intramuscular injection of 60,000 IU VD combined with lifestyle modifications over 6 months significantly improved serum ALT levels and increased adiponectin compared to lifestyle modifications alone, while preventing the worsening of IR observed in the control group
