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[4] Based on animal research, it is thought that the increased methylmalonyl-CoA hydrolyzes to form methylmalonate (methylmalonic acid), a neurotoxic dicarboxylic acid, causing neurological deterioration

This epigenetic regulation upregulates NLRP3 inflammasome activity, which subsequently triggers tubular cell pyroptosis, thereby exacerbating tubular damage and the progression of DKD (166)

Patients interested in participating in clinical trials can search for opportunities through NIHR Be Part of Research (bepartofresearch.nihr.ac.uk) or speak with their GP about eligibility

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This is why compounded semaglutide typically arrives as lyophilized powder

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