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Clinical trials utilising ALC have shown beneficial effects on nerve conduction slowing, neuropathic pain, axonal degenerative changes and nerve fibre regeneration, despite relatively late initiation in the natural history of DPN

Sample sizes were guided by prior experience with the db/db mouse model and were designed to provide 80% power ( = 0.05) to detect biologically meaningful differences in metabolic outcomes

Acknowledgements Not applicable Funding This study was supported by the Funding by Science and Technology Projects in Guangzhou (Grant Number: 202201020081)

According to a May 2025 WHO report, 2.5 billion adults worldwide were overweight in 2022, including 890 million having obesity

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Gastrointestinal symptoms typically coexist with weight loss benefits during early treatment phases