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When used in that setting, the injections may help patients stay more engaged with their goals and maintain momentum over time

59 LiC.ZhangC.QiuS.LuX.ZengY.WuH.et al (2002)

Alternatively, patients may choose a nasal spray (which requires a prescription) or an intramuscular monthly injection, also a prescription

The American Diabetes Association recommends periodic B12 monitoring in patients on metformin, with annual monitoring for those on metformin more than 4 years