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For patients on weekly dosing consider holding GLP-1 agonists a week prior to the procedure/surgery

Betaine may normalise the downstream pathways involved in insulin signal transduction, gluconeogenesis and glycogen synthesis (Reference Kathirvel, Morgan and Nandgiri33)

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These medications reduce gastric acid production, which is necessary for releasing dietary vitamin B12 from food proteins and for maintaining the stability of the B12-intrinsic factor complex

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