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In recent years, studies have emerged that have identified brain insulin resistance and impaired insulin signaling as key pathogenetic factors underlying cognitive impairment

thus even moderate CKD allows TMAO to accumulate

10.1042/BJ20031373 79 MorkholtA

The LANTUS group had a smaller mean reduction from baseline in HbA1c compared to the NPH insulin group, which may be explained by the lower daily basal insulin doses in the LANTUS group (Table 11)