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PIONEER 1 to 5, 8, and 9 were adequately powered to detect a change from baseline in A1C as the primary outcome, as well as change from baseline in body weight as the key secondary outcome (except PIONEER 9)

When butyrate binds to free fatty acid receptor 2 (FFAR2) and free fatty acid receptor 3 (FFAR3) on intestinal L cells, it stimulates GLP-1 release

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While generally safe for healthy adults, its not recommended during pregnancy/breastfeeding, with active liver/kidney disease, or if you have glutathione sensitivity