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Studies in specific populations, such as Saudi patients, have determined metabolic biomarkers and pathways in IEM disorders

What they do not have is a body of controlled evidence showing that injecting them causes clinically significant weight loss independent of diet, exercise, and the rest of a supervised program

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In cases where the MIE is unknown or undefined, the earliest known KE in the chain (i.e., furthest upstream) should be used in lieu of the MIE and it should be made clear that the stated event is a KE and not the MIE

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