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This includes confirmed low serum vitamin B12 levels, pernicious anaemia, malabsorption states such as coeliac disease, inflammatory bowel disease, or post-gastric or bariatric surgery, unexplained anaemia, neuropathy or neurological symptoms consistent with vitamin B12 deficiency, a long-term vegan diet with symptoms or low levels, or failure of oral vitamin B12 supplementation

These initiatives illustrate how short-term supply shortfalls persist despite huge investments , since biologic and peptide APIs require long lead times and sophisticated facilities to scale ( [12] ) ( [5] )

Additionally, GIP is suggested to regulate glucose homeostasis by stimulation of pancreatic alpha cells to secrete glucagon during euglycemia and hypoglycemia (17)