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Patients and clinicians often misinterpret the neurologic signs and symptoms of vitamin B12 deficiency as those of diabetic neuropathy.2 Also, vitamin B12 deficiency can increase the severity of peripheral neuropathy in patients with T2DM.6 In addition to memory impairment, neurocognitive symptoms attributable to B12 deficiency include confusion, personality changes, delirium, and depression

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Therefore, these different ADH families may have responded differently to environmental selective pressures