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Description
In recent years, there has been increasing interest in the association between metformin use and vitamin B 12 deficiency in patients with type 2 diabetes mellitus (T2DM)[15, 18]

Adjusting fiber intake may help

That finding matters enormously for GLP-1 patients
Vegetarians and those over the age of 50 years old are at higher risk of being B12 deficient

As noted, the present knowledge is limited, and these are considerations, not strong recommendations