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Importantly, the current evidence gap should not be interpreted as evidence of ineffectiveness

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The main component of ketone bodies, -hydroxybutyric acid, promotes Cu/Zn-SOD production in diabetic rats and high glucose-treated CMECs and decreases peroxynitrite levels, thereby reducing oxidative stress, inhibiting myocardial microvascular collagen 4 accumulation and antagonizing cardiac microvascular fibrosis in diabetic patients [161]