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NICE guidance on type 2 diabetes management recommends considering vitamin B12 monitoring in patients on long-term metformin, particularly those with anaemia or neuropathy

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Side effects are generally mild and manageable, usually involving only mild gastrointestinal symptoms that resolve quickly

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This creates a massive cytorheological gradient of free cytoplasmic norepinephrine, which is subsequently extruded into the synaptic cleft via transporter-mediated reverse transport (facilitated exchange diffusion) through NET (Solanki et al, 2014)