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In addition, a recent study has identified a novel variant (rs143276236) in the gene ARFGEF3 in the discovery cohort with a potential to reduce HbA1c in individuals with metformin monotherapy in African-Americans, although this find was not significant in the validation cohort (Wu et al., 2023)
There is also another major concern: safety
Without adequate glutathione in the brain, reactive nitrogen species, particularly peroxynitrite, accumulate rapidly