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For individuals who do not respond to GLP-1, this tailored, phenotype-driven methodology within a stepped-care framework guarantees more precise and efficacious interventions, affirming the early use of medication as a scientifically substantiated and personalised strategy rather than a mere pragmatic option

A growing body of experimental evidence links DKD pathogenesis and progression with intestinal dysbiosis, gut barrier disruption, and elevated levels of gut-derived microbial toxins (223)