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This situation was first reported in a boy with a deletion of exon 4 of the IGF-I gene (90) resulting in severe fetal and post-natal growth arrest, poor brain development and extreme insulin resistance with compensatory hyperinsulinemia and acanthosis nigricans

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Patients should not take supplements without professional advice

These effects will usually resolve within 48 hours but may last longer in some cases

Table 1 and Figure 6 lists several inhibitors in this category, but the most frequently reported ones are MNAM and 5-amino-1MQ (NNMTi)