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What is more, insulin stimulates PDA cells to secret Shh (sonic hedgehog), IL-6, tissue growth factor (TGF) to promote fibroblast cell growth in TAM (Mutgan et al., 2018)

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This means ketone levels can rise even when blood glucose looks normal because reduced food intake and lower insulin doses can shift the body toward fat burning

And for millions of people who struggle with obesity, a condition that affects more than a billion individuals globally, this could redefine what long-term treatment looks like.