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An increase in Clostridium species has been observed in AS (Konturek et al., 2015)

Both experimental (animals) and clinical studies have shown that many hormones can induce IR including glucocorticoids (GCs), 97 cortisol, 98 growth hormone, 99 and human placental lactogen, 100 which may decrease the insulin-suppressive effects on glucose production and reduce the insulin-stimulated glucose uptake

Empagliflozin attenuates diabetic tubulopathy by improving mitochondrial fragmentation and autophagy

While there are recommended guidelines based on gender, you should consult with a healthcare professional to determine the appropriate dosage for your needs