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Recent metabolomic studies have demonstrated that metabolic changes, including those in glucose, lipid, and amino acid metabolism, occur prior to the onset of synovitis (Hu et al., 2024

and amino acid names are given in 3 letter code with the according position

To understand the dynamics of this interplay in T1DM, one must go back to the relation between portal insulin and GHR expression on hepatocytes, which was so cleverly addressed by Leung et al

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This usually leads to intestinal leakage as well as the infiltration and metastasis of toxins and pathogenic bacteria in the intestinal cavity, which will eventually cause inflammation in the whole body