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Patients should also seek medical attention if headaches are accompanied by concerning symptoms, including: Visual disturbances such as blurred vision, double vision, or vision loss Neurological deficits including weakness, numbness, difficulty speaking, or coordination problems Altered mental status such as confusion, disorientation, or difficulty concentrating Severe nausea and vomiting that prevents adequate hydration or medication adherence Neck stiffness or photophobia (light sensitivity), which may suggest meningeal irritation High blood pressure readings, especially if 180/120 mmHg with headache Additionally, patients should consult their healthcare provider if headaches significantly interfere with daily activities or quality of life, or if over-the-counter analgesics provide insufficient relief

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In addition, treatment of a DPP-4 inhibitor in diabetic mice increased the levels of anti-inflammatory cytokines, and increased the activation of regulatory T cells, indicating an involvement in the pathology of diabetes (Tian et al., 2010)