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MOTS-c Purported Benefits: Improved insulin sensitivity Enhanced energy metabolism Potential anti-obesity effects Potential Risks and Complications: Metabolic Dysregulation: May cause hypoglycemia or hyperglycemia, leading to serious health issues

Periodic measurement of vitamin B 12 levels for individuals undergoing metformin treatment, especially if they display symptoms like anemia or PN, is integral to this integrated approach aiming to optimize metformins benefits while mitigating potential risks associated with vitamin B 12 deficiency, ensuring comprehensive patient care in the context of diabetes prevention and management [7, 46]