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In patients with impaired glucose tolerance and DPN, the staining patterns of sural nerves were similar but less intense compared with those found in patients with overt diabetes, indicating that ROS production and proinflammatory pathways are activated even before chronic hyperglycemia occurs [42]

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Both alloimmune and autoimmune responses contributed to the decrease in the grafts survival, but which one represents a more significant obstacle to the success of the islet transplantation currently remains unknown

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