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It is also possible that while heating is effective at disrupting protein shapes and eliminating enzyme activity, it does not eliminate ice nucleation activity as the proteins are twisted into new shapes that have ice nucleation sites, similar to the hypothesis that defects and aggregation of large proteins are a source of ice nucleation sites 55

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The 2022 ADA Standards of Medical Care in Diabetes guidelines propose metabolic surgery as an effective way to strongly improve glycemic control which often leads to remission of diabetes, improved quality of life, improved cardiovascular outcomes, and reduced mortality (ADA 2022)

Ann N Y Acad Sci 1112: 95103