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The mechanisms include reduction of excitotoxicity and oxidative stress, enhanced neurotrophic factor expression supporting neuronal survival, angiogenesis improving cerebral blood flow, and modulation of dopamine and serotonin systems
The underlying mechanisms of cardiovascular and renal protection differ partially between GLP1-RAs (mainly anti-atherogenic and vascular effects) and SGLT2is (primarily systemic and intrarenal hemodynamic changes)
The decision should therefore be based on an individuals nutritional status, genetic background and clinical response rather than the assumption that everyone requires methylfolate
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All authors were involved with interpretation of the data and critically revised the manuscript for important intellectual content
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