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FIGURE 6 12 Concluding remarks and future research In summary, metabolic dysfunction in T2DM affects insulin receptor signaling, inhibiting the PI3K-Akt cascade and enhancing GSK3 hyperactivity, NAD + depletion, and Sirt1/Sirt3 inactivation

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Impaired amino acid metabolism and its correlation with diabetic kidney disease progression in type 2 diabetes mellitus

A larger study is needed to confirm the significant relationships between serum L-carnitine or TMAO levels and major outcomes