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Glucagon normally signals the liver to release glucose and increases metabolic rate

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doi: 10.1186/s12902-021-00908-1 121 ShuaiYYangGZhangQLiWLuoYMaJet al

Individuals with pre-existing diabetic retinopathy, long diabetes duration (typically over 10 years), poor prior glycaemic control, and those experiencing rapid HbA1c reductions face the highest risk

This was explained by reduction of monocyte adhesion to the vessel wall and macrophage content in the plaque