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However, sustained high levels of circulating insulin may conversely exert a negative influence on cognitive function, due to prolonged peripheral hyperinsulinemia down-regulates insulin receptors at the blood-brain barrier (BBB) and reduces insulin transport into the brain, leading to brain insulin resistance (BIR) (1719)

Drug Discov Today 25(7):12391244 McCullough PA (2017) How trialists and pharmaceutical sponsors have failed us by thinking that acute heart failure is a 48-hour illness

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Nutritional status plays a role that is often underestimated

Hughes, James E