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It should be noted that uptake of Se into the brain compartment without a balanced Se-discharge mechanism could finally lead to local, brain-compartment related Se-overexposure

Nevertheless, in a cohort of Japanese patients with T2DM, decreases in HbA1c resulting from insulin treatment were associated with increases in skeletal muscle mass (measured by bioimpedance) and gait speed and, after adjusting for confounders, were associated with a 1.4% increase in skeletal muscle index over the 1-year follow-up period [77]

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These include lifestyle modification requirements (69%), trialing lower-cost medications first (63%) and limiting therapy duration (63%)