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This enzymatic barrier represents a key physiological limitation, not a formulation flaw

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These medications are administered via subcutaneous injection (with one oral formulation available) and require patient education regarding proper administration technique and storage

Factors that should alert clinicians to possible nondiabetic aetiologies include an absence of retinopathy, duration of diabetes less than five years, acute kidney injury pattern of kidney dysfunction rather than gradual progression, presence of haematuria, other systemic disease or nephrotic syndrome (albuminuria greater than 3 g/day, low serum albumin level, oedema and symptoms such as frothy urine)