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3.2 Abnormal cardiac energy metabolism In the state of diabetes, the hearts metabolic processes experience substantial alterations because of a changed metabolic environment marked by hyperglycemia, hyperlipidemia, and insulin resistance (51)

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Tein I, De Vivo DC, Bierman F et al : Impaired skin fibroblast carnitine uptake in primary systemic carnitine deficiency manifested by childhood carnitine-responsive cardiomyopathy