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Experiments both in vitro and vivo have shown that metformin attenuates the progression of DKD by suppressing renal inflammation, oxidative stress, and fibrosis (180)

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Evidence Quality Summary Honest appraisal of the evidence hierarchy for this stack: | Claim | Evidence Level | |---|---| | Ipamorelin raises GH via GHSR-1a | Strong: mechanistic + animal + human Phase I | | CJC-1295 raises GH and IGF-1 in humans | Moderate: Phase II RCT (N=65) | | Combination produces synergistic GH pulses | Moderate in animals

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