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Compared with non-diabetic kidney disease, DKD is associated with more profound depletion of SCFA-producing bacteria, resulting in reduced levels of beneficial microbial metabolites such as butyrate, propionate, and acetate (98)

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Therefore, our awareness currently must be on monitoring new drugs which could provide a putative alternative to the current duopoly (as well as drugs that could reinforce the duopoly by resulting in either NVO or LLY or both having an oral alternative)