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Also, activation of liver GH receptor, promotes IGF-I synthesis which, in turn, is released to the circulation and can be found in its free form but mainly bound to IGFBPs (overall IGFBP-3, which binds ~90% of circulating IGF-I)[23]

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Disruption of the rumen microbial network can shift metabolism into pathological states

In melanoma and breast cancer mouse models, it has been observed that mice fed a low-protein diet (4% kcal protein) exhibit reduced IGF-1 levels and slower tumor progression compared to those fed a high-protein diet (18% kcal protein)

Moreover, although preclinical studies have yielded promising results, large-scale, double-blinded clinical trials remain necessary to verify the therapeutic efficacy and feasibility of these approaches in DN patients