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After further examination of the included papers, the literature searches yielded a final result of 29 studies considered as relevant for the systematic review and 21 studies suitable for the meta-analyses

Markings run from 0 to 30 in increments of 0.5 units

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Chronic hyperglycemia and hyperinsulinemia drive a metabolic imbalance promoting oxidative stress, inflammation, and endothelial damage, responsible for non-enzymatic biomolecule glycation, accelerating cerebrovascular atherosclerosis and neurodegenerative damage that further promote cognitive dysfunction and dementia (Barone et al., 2021

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But unexpected side effects also appeared: Sexual stimulation , men and women reported spontaneous sexual arousal, men experienced spontaneous erections