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This raises peri-procedural concerns regarding anesthesia and pulmonary aspiration risks, poor visibility, and the need for repeat procedures, all of which contribute to significant time, cost, and resource burden

[2] The MHRA Drug Safety Update (August 2022) advises healthcare professionals to consider testing vitamin B12 levels in patients taking metformin who develop symptoms of neuropathy or anaemia, and to consider periodic monitoring in those at risk of deficiency

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