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Currently, seven of the top 10 causes of death globally are non-communicable diseases, accounting for 74% of all deaths, with diabetes the ninth leading cause of death [1]

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Comparison of basal insulin added to oral agents versus twice-daily premixed insulin as initial insulin therapy for type 2 diabetes

In posterior segments of the gut (e.g., the cecum and proximal large intestine), gut microbes directly cleave the CN bond of carnitine to release TMA, which subsequently enters the liver through the portal circulation, is converted to TMAO by hepatic flavin monooxygenases (FMOs) [242, 243], and eventually enters the blood circulation [244]