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Total plasma carnitine concentrations were determined in 48 out of 69 patients and were found to be rather low, as was the percentage of free carnitine
Adjustment strategies relied on measured confounders such as HbA1c and BMI but could not fully account for time-varying confounding by indication
While 2g is a moderate dose compared to clinical applications, the timing matters - delivering glutamine when plasma levels are falling prevents the cascade of muscle breakdown that occurs when stores become depleted
Patients should be instructed to report new or worsening abdominal pain, persistent nausea or vomiting, or changes in bowel habits, as these could represent medication side effects, autoimmune disease activity, or serious complications such as pancreatitis
