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Recent investigations reported that cerebral blood flow is usually increased by insulin, but that this action is blunted by insulin resistance, producing harmful effects such as mitochondrial dysfunction, oxidative stress, and decreased neuronal viability and eventually CD (van Sloten et al., 2020)

Methodological Quality Appraisal Two independent reviewers assessed the risk of bias using the Cochrane Risk of Bias Tool 1.0 [21], achieving an inter-rater reliability score of 0.86

This is vital for people with absorption issues or at risk of deficiency