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In patients with progressive -cell dysfunction, combination therapy is particularly advantageous as it focuses on multiple pathways in glucose regulation and overall increases diabetes control [33]

FIGURE 5 2.4.1 Vascular remodeling In DR, the RhoA/ROCK signaling pathway is activated by high glucose, which leads to endothelial dysfunction, breakdown of the blood-retinal barrier (BRB), and capillary leakage

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