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It has been suggested that physicians should consider screening for vitamin B 12 deficiency in diabetic patients before starting metformin therapy, and periodic monitoring of vitamin B 12 levels has been recommended for all patients using metformin, particularly for those using the medication long-term [21, 34]

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The original genetic-validation study used antisense oligonucleotide-mediated knockdown of NNMT in adipose tissue of mice on a high-fat diet, with whole-body and adipose-tissue metabolic endpoints measured against scrambled-oligonucleotide controls [2]

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