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Indeed, acute elevated peripheral insulin levels may increase insulin in cerebrospinal fluid, whereas, chronic peripheral hyperinsulinemia (such as insulin resistance or T2DM) may downregulate insulin receptors of the BBB, impair brain insulin uptake, and ultimately lead to learning, memory, and cognitive deficits (52)

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Spurred on by work demonstrating that glucose removal from the blood was more rapid with oral versus intravenously (IV) glucose in dogs (211), McIntyre et al