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Second, study populations have been heterogeneous with respect to diabetes status, obesity, renal function, baseline cardiovascular disease, and HF phenotype, which may limit generalizability
This can contribute to low iron stores, particularly in people who already have heavy periods, a restrictive diet, previous low ferritin or another source of blood loss
However, in states of leptin resistance such as obesity, this regulatory mechanism may be impaired (102, 103)
Results from large studies, such as the SELECT trial, will help doctors understand this better
The trade-off is that it requires the skin to go through a disruption phase, and many people find it hard to use consistently enough to get the full benefit