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What sets this review apart is its focus on the translational dimension: highlighting recent advances in delivery systems to overcome bioavailability challenges and identifying gaps that must be addressed through clinical research

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Baseline vitamin B12 levels before starting metformin Annual monitoring for patients on long-term metformin therapy Consideration of vitamin B12 supplementation if deficiency is detected Antibiotics and Chemotherapy Agents That Affect B12 Metabolism Certain antibiotics and chemotherapy agents can harm vitamin B12 metabolism

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