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1,50,51,52 Insulin resistance, even without overt hyperglycemia, independently increases DN risk by causing peripheral nerve damage

A low fermentable oligo-, di- and monosaccharides, alcohols and polyols diet is characterized by an exclusion of all dairy products, all cereals except rice, cashew, all fruit other than banana, citrus, pineapple, red berries, strawberries and kiwi, and all vegetables other than pumpkin, cabbage, lettuce, tomato, carrot and cucumber, for a 4-week period [34]

Additionally, the duration of therapeutic effects can be limited, with some patients experiencing relapses shortly after treatment (186)

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Hierarchical clustering analyses showed an association between brain IR and specific clinical symptoms, with the highest levels of IRS-1 in L1CAM exosomes associated with suicidality, anhedonia, depressed mood and feelings of guilt

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