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According to American Diabetes Association guidelines, treatment should be individualized based on patient tolerance, efficacy, and overall benefit-risk profile

Severe B3 deficiency (pellagra) causes gastrointestinal, dermatological, and neuropsychiatric symptoms including depression, insomnia, and hallucinations that can either mimic or intensify withdrawal symptoms

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This could potentially lead to autoimmune disorders or increase susceptibility to infections

This complex assessment could help to cluster patients into subgroups that can be better explained by specific biological dysfunctions