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L-Carnitines effects require a buildup period to experience changes in exercise performance, but it can help enhance fitness in several ways

Most are broken down by stomach acid before they ever reach the bloodstream

We further excluded individuals with a history of treatment with insulin before their initial prescription for a non-insulin glucose-lowering drug (since insulin therapy at baseline is considered for patients with advanced disease), women with a history of polycystic ovary syndrome or gestational diabetes, and individuals with type 1 diabetes

Philippaert K, Pironet A, Mesuere M et al (2017) Steviol glycosides enhance pancreatic beta-cell function and taste sensation by potentiation of TRPM5 channel activity

And the food is low calorie and nutrient dense which, if that had been the primary food source in the first place, we may not have needed the drug have I missed something here