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If interventions are not started, the increased demand for insulin can overload pancreatic -cells leading to pancreatic -cell failure, decreased insulin secretion, and uncontrolled glycemia (Figure 1)

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(source) A 2017 meta-analysis did not support the suggestion that treatment with GLP-1 agonists or DPP-4 inhibitors increased all-cause mortality in type 2 diabetics

Butyrate is associated with a spectrum of health benefits including healthy blood sugar response, gut permeability, and immune function