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[DOI] [PubMed] [Google Scholar] [20].Alblowi J, Kayal RA, Siqueria M, McKenzie E, Krothapalli N, McLean J, Conn J, Nikolajczyk B, Einhorn TA, Gerstenfeld L, Graves DT, High levels of tumor necrosis factor- contribute to accelerated loss of cartilage in diabetic fracture healing, Am

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The clinical presentation can be insidious, with symptoms developing so gradually that patients may not recognise the changes until deficiency becomes severe