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These cascades involve the activation of NF-B and MAPK pathways, upregulation of inflammatory cytokines, and overproduction of reactive oxygen species (ROS), collectively accelerating cellular senescence and tissue degradation 8,9,10,11,12

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As the main problem lies in the lack of endogenous insulin production, all T1DM subjects will have low portal insulin levels, even when treated with subcutaneous insulin, as this will only increase systemic insulin concentrations