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The story extends beyond biology into behavior, where the impact shows up clearly in the data

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Importantly, comorbid T2DM or elevated peripheral IR accelerate disease progression in AD and PD independently of vascular disease, with higher peripheral IR predicting conversion from mild cognitive impairment to AD (12, 13) and faster motor and cognitive decline in PD (14, 15), thereby implicating IR as a modifier of NDD biology rather than a simple comorbidity

The human microbiome in health and disease: hype or hope