GPT and diabetic kidney disease: Three SRs providing moderate (1/3) and low (2/3) quality of evidence demonstrated the intervention with TWP on DKD increased the ALT level [14, 17, 25], with the pooled effect ranging from 1.17 U/L (95% CI: 0.54 to 1.80) [17] to 3.75 U/L (95% CI: 2.98 to 4.53) [25].