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Acknowledgments The authors would like to thank the Long Island University Dassault Systmes Centre of Excellence for their financial and resource support

In childhood the disease normally takes a much more aggressive course than when it appears in teenagers and young adults

Baseline bloodwork should include a comprehensive metabolic panel, fasting insulin, fasting glucose, HbA1c, lipid panel, liver enzymes (AST and ALT), IGF-1 levels, thyroid panel, and for men, testosterone levels