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22, 2016) concluded: Long-term use of metformin in DPPOS was associated with biochemical B12 deficiency and anemia

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60 The metformin-induced decreased gluconeogenesis from the liver by AMPK-independent processes including dampening the activity of glucagon, blocking crucial enzymes of gluconeogenesis like fructose-1,6-bisphosphatase-1 and glycerol-3-phosphate dehydrogenase and enhancing glucose uptake by increased GLUT1 activity and IRS2 hence leading to reduction in plasma glucose levels