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Dosage may be reduced to 0.5 mL weekly in patients experiencing gastrointestinal intolerance or increased to a maximum of 2 mL twice weekly for short-term metabolic intensification when supervised by a qualified clinician

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A multicenter trial of 390 patients with diabetes mellitus receiving insulin therapy who were randomized to receive metformin, 850 mg three times daily, or placebo assessed the risk of vitamin B 12 deficiency and low vitamin B 12 levels over four years