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It's the toxic load, it's the nutritional deficiencies, it's the low grade inflammation from multiple causes, the shifts in the microbiome, autoimmunity itself

Regarding the causal relationship between BCAAs and IR, two main hypotheses currently exist: sustained high BCAA levels interfere with insulin signaling through mTOR complex 1 (mTORC1) activation leading to insulin receptor substrate-1 (IRS-1) serine phosphorylation

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However, the mesotherapy pen significantly improves results by creating micro-channels that deliver active ingredients 35x deeper into the skin directly to the dermal papilla where hair follicle stem cells reside

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It has been shown that human skeletal muscle cells (hSMC), isolated from diabetic patients, after a 24-h culture generate significantly more TNF-, IL-6, IL-8, IL-15, monocyte chemotactic protein (MCP)-1, Growth-Related Oncogene (GRO)-, and follistatin compared to non-diabetic individuals (113)