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When it happens, its usually tied to the things that come with heavy kratom use rather than the kratom itself: poor sleep, stress, weight changes, or nutritional gaps

People with diabetes (which affects kidney health over time)

Allowable carbohydrates come primarily from non-starchy vegetables: leafy greens, broccoli, cauliflower, zucchini, asparagus, green beans, cucumbers, celery

Physiologically, it can bind to GLP-1 receptor on pancreatic beta cells through endocrine, activate adenylate cyclase, increase intracellular cAMP levels, promote glycolysis and ATP production, and enhance glucose-stimulated insulin secretion