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Diabetic Medicine, 28 (8), 972975
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Metformin, the first-line treatment for T2D, induces vitamin B12 deficiency through calcium-dependent antagonism of the intrinsic factor-B12 complex absorption in the terminal ileum, with studies showing a 13% increased risk of deficiency per year of use and higher prevalence in patients using metformin for more than 4 years at doses exceeding 1000 mg daily [158]
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