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61 On the other hand, adipocyte inflammation is increased

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1,2 Following a meal, GLP-1 facilitates glucose-dependent insulin secretion from pancreatic -cells, suppresses glucagon release from -cells, and slows gastric emptying, all of which moderate glucose excursions following nutrient intake

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Elevated blood glucose triggers hyperglucotoxicity, leading to aggravation of IR and deterioration of cell function, creating a vicious cycle that leads to further elevation of blood glucose to diabetic levels and even hyperglycemic crises

Additionally, environmental factors such as iodine excess or deficiency, smoking, stress, exposure to chemicals, medications (e.g., amiodarone, interferon-), and some viral/bacterial infections can alter gene expression patterns through epigenetic mechanisms and trigger autoimmune processes