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Insulin resistance, hyperinsulinemia, dyslipidaemia, and obesity precede the progression to T2D in 7585 % of patients [65], and the presence of MetS increases up to fivefold the risk for T2D compared to individuals without MetS [66, 67]

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Ann Rheum Dis (2013) 72(1):1107

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Other significant factors include genetic variations, nutritional deficiencies of cofactors (copper, zinc, manganese), overwhelming oxidative stress, and inflammatory conditions that alter SOD expression or activity

This approach risks receptor desensitization, increased cost, and diminishing returns