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It has attracted attention because laboratory and animal studies suggest that inhibiting NNMT may influence fat metabolism, energy expenditure, and insulin sensitivity

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A retrospective study looking at concomitant use of proton pump inhibitors (PPIs) alongside metformin in 614 people with type 2 diabetes in the US found a significant reduction in B12 levels of 34% in patients taking both medications, compared to controls taking either drug alone (Long et al, 2012)

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The injectable form is typically used when oral administration is not feasible or not sufficiently effective