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Qin, J., Goswami, R., Balabanov, R

observed that metformin use was associated with an increase in homocysteine levels, but vitamin B 12 did not vary significantly

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Drug-induced malabsorption: Long-term medications like metformin or proton-pump inhibitors can reduce B12 absorption

The biggest change to current clinical practice is likely to be the advice to consider periodic monitoring of B12 levels in patients taking metformin who are at risk of deficiency, which includes a wide range of our patients living with type 2 diabetes