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14,21 In addition, increased serotonin levels, 22 altered bile acid metabolism, 2325 altered microbiome, 2628 reduced counterregulatory hormones in response to hypoglycemia, 21,29,30 increased proinflammatory signaling, 32 and intestinal upregulation of glucose transporters 33 have also been found to contribute to PBH pathophysiology (Figure 2)

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