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Additionally, NAD + is required for fatty acid metabolism during -oxidation, glutaminolysis generating -ketoglutarate, mitochondrial shuttling of metabolites, and lactic acid fermentation 35

This applies also to acute complications of diabetes - ketoacidosis, hyperglycaemic-hypermolar state, recurrent and severe hypoglycaemic episodes

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This suggests that under T2 stressed conditions, increases in SLC7A11 activity help maintain intracellular redox balance (Figure 3G)