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Additionally, rapid improvements in blood sugar control in diabetic patients may unmask or allow recognition of pre-existing depression that was previously masked by metabolic dysfunction

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It usually increases rapidly in size to several centimetres and is characterised by acanthosis and spongiosis of the affected epithelium with dendritic melanocytes dispersed throughout the thickness of the epithelium, with a mild inflammatory cell infiltrate in the superficial lamina propria [11, 13, 34]

In the current review, we detail the ability of the gut microbiome to impact small intestinal nutrient-sensing mechanisms that activate a gutbrain neuronal axis to regulate hepatic glucose production