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Animal studies indicate fetal growth restriction, ossification delay, skeletal variants, and reduced maternal weight gain, though more recent human evidence, including a 2024 cohort of 938 pregnancies, suggests no increased risk of major congenital malformations compared with insulin

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This direct delivery method ensures nearly 100% bioavailability, whereas sublingual drops achieve only 5-15% of the dose reaching the bloodstream in therapeutically active form

Treatment should include, in addition to L-carnitine, supportive and other therapies as indicated by the condition of the patient

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