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In a recent review by Blaine et al

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Detoxification : Boosts liver function and helps cleanse the body of toxins

Severe gastrointestinal condition (gastroparesis, inflammatory bowel disease) 10

You may also need vitamin B-12 injections or supplements if youre experiencing symptoms of vitamin B-12 deficiency

The leading hypothesis to reconcile these findings is the early worsening phenomenon, where rapid and substantial glycemic improvement temporarily exacerbates pre-existing DR