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Despite that, patients carrying this protective variant showed lower insulin autoimmunity, residual cell function, higher C-peptide levels, better glycemic control, and a lower risk for diabetes complications (65, 66)

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Furthermore, ROS-induced activation of the TGF-/Smad signaling pathway promotes tubulointerstitial fibrosis, further compromising the expression environment of OCTN2 and aggravating carnitine loss [134]

doi: 10.1016/j.cgh.2021.02.031 32 LiuY-BChenM-K

5 They went on to say that hospitalizations and more severe symptoms also increased during this time, though these primarily resulted from unintentional ingestions