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The fairest one-line summary is that DSIP appears to have real biological activity but a weak and inconsistent clinical efficacy signal

This allows many patients to achieve NICE-recommended HbA1c targets (typically 53 mmol/mol or 58 mmol/mol depending on individual circumstances) without requiring insulin therapy

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Beyond simple actin sequestration, Bock-Marquette and colleagues reported in Nature (2004) that T4 activates integrin-linked kinase and Akt, promoting cardiomyocyte and epicardial cell migration and survival in mouse cardiac injury models, which established a signalling role separate from cytoskeletal buffering