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One case study involving a child with one pathogenic ACADVL mutation showed that it combined with common ACADVL variants to cause significantly reduced enzyme function.[ref] Another study in infants with a positive newborn screening for decreased VLCAD showed that they had a single copy of a mutation in the ACADVL gene

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Other errors may include not rotating injection sites, reusing the same needle, not verifying that the dose is as prescribed, not holding the dose button down until the dose counter shows zero

Adjust Your Injection Timing Some people find that taking their GLP-1 injection at night instead of in the morning helps reduce nausea during the day