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Hormonal change in perimenopause itself affects the gut microbiome, which means the gut and hormones are influencing each other in both directions

At the immunological level, reduced butyrate availability may impair regulatory T cell differentiation [122]

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On the basis of insulin initiation therapy, further optimization of the treatment plan is required if the patient's blood glucose level still does not reach the standard or if recurrent hypoglycemia occurs after adequate dose adjustment

Yes, when prescribed by a licensed physician at a regulated clinic such as Revival Clinics