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Key Mechanism: Fiber slows digestion Reaches the colon fermented by gut bacteria Produces compounds that trigger GLP-1 release Two-Phase Effect: Immediate GLP-1 release after eating Second boost (48 hours later) Second Meal Effect Helps: Reduce cravings between meals Improve next-meal appetite control Best Fibers for GLP-1 Fermentable Fibers (Most Effective) Beta-glucans: Oats Barley Rye Seaweed Mushrooms Other Soluble Fibers Apples Pears Legumes: Lentils Chickpeas Peas 2

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SGLT2 inhibitors, used in the treatment of type 2 DM, have an average half-life of 11-13 hours, so most articles suggested withholding the drug three days before any elective surgery but some articles suggested a longer withholding period based on other precipitating factors contributing to euglycemic DKA

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Chronic inflammation in type 2 diabetes (T2D), characterized by constitutively activated immune cells and elevated pro-inflammatory mediators along with hyperglycaemia and increased free fatty acids and branched chain amino acid levels, significantly alters the immuno-metabolic axis