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Besides, the cost deters it from making its way into low- and middle-income countries, where people are not only most affected by obesity, but are also at risk of cardiovascular death, where it makes up nearly 80% of the global burden, according to the National Institutes of Health
The American Diabetes Association (ADA) recommends considering periodic measurement of vitamin B12 levels in patients with type 2 diabetes taking metformin, particularly those with anemia or peripheral neuropathy, though no specific monitoring interval is specified
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