ACADM and hyperinsulinemic hypoglycemia, familial, 4: Enzymatic defects in fatty acid oxidation may concern very-long-chain fatty acids acyl-CoA dehydrogenase (VLCAD), medium-chain acyl-CoA dehydrogenase (MCAD), long-chain 3-hydroxyacyl-coenzyme A dehydrogenase deficiency (LCHAD), CPT-2, and CACT deficiency, which may cause secondary carnitine deficiency [109,113].