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NICE guidance on type 2 diabetes management recommends considering vitamin B12 monitoring in patients on long-term metformin, particularly those with anaemia or neuropathy

First, the surgeon will divide the stomach to create a small stomach pouch

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Step-by-step cold compress protocol: Timing: Apply within 1 hour of noticing the reaction for best results Preparation: Wrap ice pack or frozen gel pack in a thin cloth or paper towel, never place ice directly on skin Application: Press gently against the affected area for 10 to 15 minutes Frequency: Repeat every 2 to 3 hours during the first 24 hours Duration: Continue cold compress therapy for the first 48 hours Safety: Never exceed 15 minutes per application, check skin for signs of frostbite (white, waxy appearance) A pre-injection cold application also helps