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Is there a reason that happens? I suppose it's quite important to recognise the issue and address it and if an injection is required it's at least better than the alternative.

It mostly happens when I have to go on a super low carb diet for a few months, where daily carb intake is as close to 45 grams as I can get it, which is about 3 slices of bread. So about every two years.

Hmm yeah, it seems that no matter what we do there's implications.