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Future research is needed to validate the initial findings suggesting a link between persistent enteroviral infection and T1D onset by conducting larger, multicenter studies to increase statistical power and overcome the limitations imposed by small sample sizes in current pancreatic tissue and interventional trials, including the DiViD

Adding GIP (the tirzepatide model) deepens the effect and, somewhat counterintuitively, appears to improve gastrointestinal tolerability relative to GLP-1 alone

A subsequent study of the same region reported increased TRP levels and an elevated KYN/TRP ratio, with KP activation extending to the downstream metabolite 3-HAA [234]

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doi: 10.1152/ajpcell.1996.271.3.C851