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According to OBRA, the use of antidiabetic medications should include monitoring (e.g., periodic blood glucose) for effectiveness based on desired goals for that individual and to identify complications of treatment such as hypoglycemia or impaired renal function

However, the findings also highlight concerns about the heavy involvement of drug manufacturers in many of the studies

Given the inconvenience of regular intramuscular injections and the evidence from several trials demonstrating the effectiveness of the oral route in normalizing vitamin B12 levels [57,73], we initially suggest a trial of oral replacement