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If a beta-blocker is combined, a vasodilator beta-blocker, including Carvedilol or Nebivolol, may be preferred because non-vasodilator beta-blockers accelerate albuminuria progression ( In patients with DKD, SGLT2i or MRA can be added when the target urinary albumin levels are not achieved with RAS blockade (Piperidou et al., 2019)

doi: 10.1007/s00299-017-2139-7 46 PascualL

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Lactate recycling : it converts lactate, produced via extrahepatic anaerobic glycolysis, back into glucose through hepatic and renal gluconeogenesis