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The pathogenesis of DN is complex, with oxidative stress (OS) emerging as a key factor contributing to nerve damage through mechanisms like lipid peroxidation, protein modification, and DNA damage

However, it supports the gut ecosystem that regulates GLP-1 secretion by supporting gut barrier and intestinal lining health , participating in short-chain fatty acid (SCFA) cross-feeding networks, and stabilizing enteroendocrine L-cell signaling environments

JAMA, 329(16), 14011401