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These are the same countries where noncommunicable diseases like heart disease and diabetes now account for 82% of premature deaths

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deficiency causes megaloblastic anaemia, resulting in fatigue and reduced oxygen delivery to tissues [2] [17] Impact on circadian rhythms is an emerging area of research

If diabetes is due to another disease (like pancreatitis, cystic fibrosis, etc.): 2

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Diseases or anatomy changes that affect the flow of pancreatic juice will lead to EPI