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And it is confusing when I tell patients that all these symptoms are predictable, expected, and related

Therapeutic strategies that target this axis, using probiotics, prebiotics, synbiotics, dietary interventions, or fecal microbiota transplantation, and, more experimentally, genetically engineered strains capable of local hormone or peptide delivery in the gut, offer the possibility of indirectly supporting -cell function by attenuating metabolic stress and inflammation and restoring a more favorable incretin milieu

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There is no way to know whether the next batch, or the batch before, or the batch six months later, contained the same quality product