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8 Under diabetic conditions (eg, hyperglycemia and dyslipidemia), neural structure is disrupted, accompanied by bioenergetic deficits, impaired insulin signaling, inflammation, oxidative stress, microvascular damage (Figure 1b)

Gradients of oxygen and nutrients from the surface to the deeper layers lead to altered bacterial metabolic activity, with dormant bacteria in the deep layers exhibiting stronger drug tolerance (Liu et al., 2024)

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[2] If symptoms are severe or persistent, it's important to discuss them with your healthcare professional