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A cross-sectional, controlled study on Metformin that included both diabetic and non-diabetes patients showed no that irrespective of Metformin use, no significant difference in the serum levels of vitamin B12 was observed, both in patients with and without diabetes (5)

Key gaps to address: dose-response in humans, safety/tolerability profiles across populations, interaction effects in stacks, and long-term cardiometabolic outcomes

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References Campbell, R., Bellolio, F., Motosue, M., et al