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An enzyme drives this conversion, and it increases its activity under the influence of insulin

Mutat Res Genet Toxicol Environ Mutagen (2016) 810:229

And, concerning the role of GUT health, many other factors, including nutrition, prebiotics, additional microbe-derived metabolites such as short chain fatty acids (SCFA), along with avoidance of unnecessary antibiotics, warrant study in T1D ( 3.3 Crosstalk between gut microbiota and the pancreatic islet The human gastrointestinal tract from the oral cavity to colon harbors distinct microbial ecosystems

The small handful of human studies that made note of side effects found either no reported side effects or a couple of minor side effects

ACE2 counters the activity of ACE by reducing the amount of angiotensin-II (ANGII) and increasing ang (1-7) peptide