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Thiamine, essential for ATP production and neurotransmitter synthesis (GABA, acetylcholine), plays a key role

The ability of ceramides to interfere with insulin receptor signaling is the result of blocking the receptors ability to activate the downstream effector kinase, AKT/PKB

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Early report indicated that sensitivity of NBS for CUD was not perfect.29 So, there is a small proportion of clinical CUD cases that might be missed by NBS and will present at the time of metabolic derangement or cardiomyopathy