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Therefore, mechano-energetic uncoupling imposed by increased hemodynamic load, which hampers mitochondrial ROS detoxification, rather than an increase of ROS production at the respiratory chain per se, as has been observed in large animal models with HF with reduced ejection fraction (HFrEF) [24] may underlie the increase in oxidative stress in HFpEF induced by DM and CKD

These include: Neurological symptoms : tingling or numbness in hands and feet (peripheral neuropathy), difficulty walking or balance problems, memory difficulties, or mood changes including depression Haematological signs : persistent fatigue, weakness, pale or jaundiced skin, or shortness of breath Glossitis : a sore, red, smooth tongue Cognitive symptoms : difficulty concentrating, confusion, or "brain fog" Seek urgent medical attention if you experience rapidly worsening neurological symptoms, significant difficulty walking, severe paraesthesia, or marked cognitive decline, as these may require immediate assessment