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When joints are inflamed, they produce excess reactive oxygen species (ROS), which include superoxide and hydrogen peroxide, to the point that they overwhelm the bodys defences and deplete the local glutathione supply [6]

In contrast, a multicenter retrospective cohort study, including a higher-risk population (23% with CKD) reported slower eGFR decline and lower risks of CKD progression and doubling of serum creatinine among SGLT2 inhibitor users compared with GLP-1 receptor agonist users

This process is marked by Fe overload, GSH depletion, and mitochondrial shrinkage

Since then, there have been no large-scale clinical trials of GLP-1s or SGLT-2s in people with type 1 diabetes