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The biggest change to current clinical practice is likely to be the advice to consider periodic monitoring of B12 levels in patients taking metformin who are at risk of deficiency, which includes a wide range of our patients living with type 2 diabetes

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Funding We thank the Shandong Provincial Natural Science Foundation (ZR2021QB172), Key R&D Program of Shandong Province, China (2023CXPT012), Taishan Scholars Construction Engineering to GT (tstp20221145), National Natural Science Foundation of China (31771284), Taishan Scholars program to ZY (tsqn201812100), Shandong Provincial Natural Science Foundation (ZR2021MH292), Shandong Provincial Natural Science Foundation (ZR2021MH141), BZMC Scientific Research Foundation (BY2020KYQD08) for financial support of this study

H., Ibrahim, A., Zhao, Y

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