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The mechanism of peripheral edema is unknown but may share vascular regulatory pathways with DME, the authors wrote, as the meds may increase VEGF concentrations in retinal cells. Since millions of patients with diabetes take calcium channel blockers, even a small differential risk in DME development could translate to a significant DME disease burden, they wrote

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They may consider alternative antiemetics, delaying dose escalation, stepping back to a previously tolerated dose, or temporarily interrupting treatment to find the optimal balance between symptom control and therapeutic benefit

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