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Many providers use Tesofensine as an add-on rather than a replacement because it helps increase energy expenditure while the GLP-1 continues appetite regulation

The predicted inhibitor-binding mode of 1j with an orientation and conformation that favors most negative docking score when superimposed with the endogenous substrate NCA of the NNMT enzyme indicated that the analog binds consistent with the binding mode of NCA, i.e., the N1-atom of both ligands aligned almost identical, conferring similar molecular interactions with key residues within the active site of the enzyme

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167,171,172 Management strategies focus on tight glycemic control to prevent further nerve damage, symptomatic treatment with analgesics for pain management, physical therapy to maintain muscle strength and prevent contractures, and surgical interventions for entrapment neuropathies when necessary

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