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The Grading of Recommendation, Assessment, Development, and Evaluation (GRADE) tool was used to assess the certainty of the evidence for the two primary biochemical outcomesserum vitamin B12 concentration increase and homocysteine reductionacross all included studies, and separately for randomised controlled trials (RCTs) and observational studies

Thus, where genotype is known, there is a strong case for initiating serum vitamin B 12 monitoring from initiation of metformin treatment in people with the AA genotype but deferring this until 10 years of treatment in the rest of the population who have no other risk factors

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For semaglutide (5 mg vial), 1.5 mL of water gives 3.33 mg/mL