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An increase in metHb levels and in its linkage to the RBC membrane, accompanied by ROS formation, was also found in stored RBCs for blood transfusion [30] and in exogenous H 2 O 2 -induced OS upon healthy erythrocytes [31, 32]

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The latter represents the ultimate pathological change in DN (130)

Understanding these distinctions helps patients and providers engage in informed conversations, rather than viewing the peptides as competing or interchangeable options

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