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Perhaps the observed downregulation of these carnitines after treatment administration is indicative of altered metabolic pathways in energy metabolism, which has been observed in conditions with increased catabolism (e.g., senile dementia, metabolic nerve diseases, tuberculosis, myopathies and cardiomyopathies) 47
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Ries, L
However, the maximal glycaemic effect is usually seen after several months and following dose titration, not immediately upon reaching steady state