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Conditions for which this effect has been demonstrated are: glutaric aciduria II, methyl malonic aciduria, propionic acidemia, and medium chain fatty acylCoA dehydrogenase deficiency.7,8 Autointoxication occurs in these patients due to the accumulations of acylCoA compounds that disrupt intermediary metabolism

The degree of stimulation is adjusted for each patient so it is close to the threshold at which the electrical impulse can be felt (Duelund-Jakobsen 2013

Immediate triggers are often indirect, including low blood sugar, dehydration, and anxiety, and clinical trials observed increased heart rate in roughly 2 out of 100 patients, which supports investigating reversible causes first

Our objective herein was to determine whether this intrinsic islet defect was related to chronicity of exposure