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There must be a few other options - so why haven't they been eliminated as possibilities

In type II diabetes, the number of docked granules is about 1/3 lower than in normal cells, and the rate of glucose-stimulated exocytosis is only 20% of that in normal cells ( 8 IAPP and diabetes Type II diabetes can be characterized as a protein-misfolding disease, and the protein involved in its pathology is hIAPP/amylin

Kassubek J, Stocchi F, Martinez EB, Pahwa R, Ondo W, Zhang Y, et al

This is "after" photo material that looks like a different person

Extended therapy with intravenous arginine butyrate in patients with beta-hemoglobinopathies