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Increased permeability of the gut barrier has been observed to occur with a variety of physiological stressors including heat stress [4, 5], exercise stress [6], psychological stress [7], excessive dietary fat intake [8], lack of fibre [9], and sleep deprivation [10] many of these are also risk factors for hypertension [11, 12]

10.1111/j.1365-2443.2010.01473.x 83 VousdenK

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This was notably not due to any new safety concerns and may potentially be driven by the manufacturers reluctance to introduce a black triangle to ensure clinician and patient awareness of the increased monitoring requirements in type 1 diabetes [29]