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It could be peripheral artery disease

Accordingly, the probable mechanisms could be discussed in four main approaches, namely, modulation of gut microbiota dysbiosis, production of SCFAs, reduction of gut permeability and metabolic endotoxemia, and regulation of bile acid metabolism (32, 35, 36)

In situ hybridization (ISH) studies have revealed that GLP-1R mRNA is also expressed in the human brain PVH, with its expression significantly reduced in T2DM patients compared to controls, potentially contributing to homeostatic imbalance [90]

If you pursue compounded GLP-1 medications, ensure the prescription comes from a licensed provider and is filled by a state-regulated 503A or 503B pharmacy