One cause of B12 deficiency includes pernicious anemia, a condition that results in a reduction of red blood cells when the intestines cannot absorb enough vitamin B12
The intensive treatment of the multiple risk factors reduces the development/progression of renal disease18 which is why guidelines insist on comprehensive management of the patient with diabetes (glycemic control and control of cardiovascular risk factors, use of renin-angiotensin system inhibitors, as well as lifestyle changes, including smoking cessation or weight loss in overweight/obese individuals, among others).19 However, the residual renal risk remains very high in optimally treated patients.20 More recently, iSGLT2 has been shown to reduce the risk of cardiovascular and renal events, but still, the residual risk of renal disease progression remains high.21,22 Nevertheless, although the rate of diabetes-related complications (such as myocardial infarction, stroke, lower limb amputations or mortality) have decreased significantly in recent decades, this is not the same for CKD patients requiring renal replacement therapy attributed to diabetic kidney disease (DKD).23 Therefore new treatments are needed that improve glycemic control independently of GFR, with a low risk of hypoglycemia and able to reduce cardiovascular and renal risk in this population
& Yamamoto, K
Although the function of GSH as an antioxidant or conjugate in detoxification has been extensively characterized, its role in the regulation of cystine-mediated signaling and cell growth is largely unknown
these medications save lives and work much better with even modest lifestyle changes
Not tendons
