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Hormonal changes: Hormonal fluctuations, such as those during menstruation, menopause, or puberty, can affect blood sugar regulation in some individuals

"The effects of L-carnitine supplementation on cardiovascular risk factors in participants with impaired glucose tolerance and diabetes: a systematic review and dose-response meta-analysis." Diabetology & Metabolic Syndrome

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10.1038/nrcardio.2014.28 231