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In the vascular system, oxidative stress in diabetes activates ROS-mediated Akt and extracellular signal-regulated kinase 1/2 (ERK1/2) signaling cascades, promoting autophagy in endothelial cells while downregulating HDAC6 expression, which impairs cell migration and adhesion

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Compared with insulin therapy, they achieve similar overall glycemic control, while avoiding insulin-associated adverse effects in T2DM (17)