Caused most commonly by pernicious anaemia (autoimmune condition), dietary insufficiency in vegans, malabsorption disorders, or gastrointestinal surgery affecting B12 absorption
This is one reason patients may feel satisfied with smaller meals
Fiber rich foods help with digestive side effects and help maintain blood sugar while foods low in fat can minimize heart burn, nausea, and vomiting
In this condition: Many patients have elevated insulin levels long before fasting glucose or hemoglobin A1c become abnormal
Improved gut microbiota : There is recent evidence that suggests that metformin may also positively impact the composition of gut bacteria, which can have implications for weight regulation and metabolic health
Continue covering weight loss drugs and raise premiums for everyone, or restrict coverage and protect the broader member pool from unsustainable cost increases