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The specific reasons identified include intensive insulin therapy, decreased renal function, severe liver disease, alcohol ingestion, defective counter regulatory hormone release, missing meals/fasting, and gastroparesis

doi: 10.1089/jwh.2007.0594 63 RacineSECulbertKMKeelPKSiskCLAlexandra BurtSKlumpKL

Symptoms may also appear after increasing the dosage because the digestive system must adjust again

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Bariatric Surgery versus Intensive Medical Therapy for Diabetes 5-Year Outcomes