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While this interaction primarily affects dietary B12 absorption rather than injected cyanocobalamin, patients on long-term acid suppression therapy may have depleted B12 stores that require consideration when initiating treatment

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[2] [5] The Medicines and Healthcare products Regulatory Agency (MHRA) approved semaglutide for diabetes management, and NICE guidelines (NG28) recommend GLP-1 receptor agonists as part of a comprehensive treatment strategy for appropriate patients

In practice, combining medication, exercise, and dietary improvement is likely to be more effective than any single approach alone

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