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doi: 10.1093/rheumatology/kes242

Physiology, Glucose Metabolism

Conversely, discontinuation rates were increased to 33.7% (95% CI 33.4, 34.0) at 1 year and 50.6% (95% CI 50.3, 50.9) at 3 years when using a grace period of 60 days (ESM Table 4)

Increased intestinal permeability ("leaky gut") allows bacterial lipopolysaccharides (LPS) to enter the bloodstream, triggering systemic inflammation that impairs insulin signaling