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Every individual has a certain capacity to process and eliminate histaminethis is their "bucket." Histamine enters the bucket from multiple sources: it is produced endogenously by mast cells and basophils, synthesized by certain bacteria in the gut microbiome, and ingested directly through histamine-rich or histamine-liberating foods (such as aged cheeses, fermented foods, and certain fruits)

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Most patients had diabetes with complications: 66.5% and 66.9% of patients had diabetes ketoacidosis or uncontrolled diabetes, 15.1% and 15% had documented hypoglycemia within the GLP1-RA and DPP4i groups, respectively