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Consequently, they may exhibit undefined or broad specificity and relatively high equilibrium dissociation constant (Kd) values for their targets [442]

Nevertheless, use of metformin may decrease vitamin B 12 status: a meta-analysis of four short-term intervention trials (up to 4 months duration) in patients with type 2 diabetes found that metformin use decreased serum cobalamin concentrations by 57 pmol/L, which could have clinical implications if such patients have suboptimal vitamin B 12 status (146)

doi: 10.1016/j.jhepr.2025.101363, 21

Consult your prescriber before adjusting increasing dose without addressing those variables wastes the injection

Approval of additional GLP-1 agonists has reduced injection burden to weekly and recently an oral GLP-1 product was approved

- [Stability of GLP-1 Receptor Agonist Peptide Formulations Under Refrigerated Conditions]( *International Journal of Pharmaceutical Compounding*, 2022