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This is possible due to the extraordinary ability of the gonococcus to modulate the interaction with different types of cervical epithelial cells in the female tract, using distinct mechanisms, including the modulation and control of distinct epithelial cell-cell adhesion complexes through the manipulation of host cell signaling and the ability to survive intracellularly within a gonococcal-containing vacuole (Song et al., 2020)

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Critically, the study documented no significant changes in oral glucose tolerance tests, no alterations in fasting insulin levels, and no changes in serum IGF-1 concentrations across all treatment groups

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