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If denied, file an appeal many properly documented appeals are overturned in national analyses

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Evaluation should include serum electrolytes and ketones, blood glucose and, if indicated, blood pH, lactate, pyruvate, and metformin levels

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Third, the study did not recruit a sufficient number of participants to assess outcomes in those with BMI less than 25 kg m 2 or to assess outcomes of metabolic syndrome (for example, blood pressure, lipid profile, metabolic dysfunction-associated steatotic liver disease)