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This subtype features fluctuating tinnitus, where symptoms change in character or volume throughout the week

Under high-glucose conditions, the accumulation of lipid hydroperoxides in cell membrane structures increases membrane permeability, thereby inducing ferroptosis and exacerbating renal damage in DN

Abdominal fat increases intra-abdominal pressure, forcing stomach contents upward against the lower esophageal sphincter

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Other treatments, including omega-3 fatty acids and emerging therapies such as IVIg and therapeutic apheresis, offer moderate improvements but require further validation through larger, well-designed clinical trials