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Proteomic analysis showed that these significantly differentially expressed proteins are involved primarily in metabolic pathways including carbon metabolism, amino acid biosynthesis, pyruvate metabolism, glucagon signaling, pentose phosphate pathway, HIF-1 signaling and glycolysis/gluconeogenesis (Figure 4C)

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Association of vitamin B12 deficiency in people with type 2 diabetes on metformin and diabetic peripheral neuropathy Nature article: Shows prolonged metformin use correlates with lower B12 and more severe diabetic neuropathy