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When acid reaches the throat, it can irritate and inflame the vocal cords, which may affect the voice. Importantly, Jelly Roll has been clear that his choice isnt a judgment on anyone elses

doi: 10.3389/fimmu.2019.01223

The relationship between diabetes and cognitive impairment involves many aspects, including central insulin signal transduction, nerve fiber damage caused by hyperglycemia, neuritis, oxidative stress, bloodbrain barrier damage, vascular neuropathy, changes in the dopaminergic system, and the effects of advanced glycation end products on metabolism and energy (Figure 1)

8.6 Renal Impairment JANUMET JANUMET is not recommended in patients with an eGFR between 30 and less than 45 mL/min/1.73 m2 because these patients require a lower dosage of sitagliptin than what is available in the fixed dose combination JANUMET product