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References Acharya SK, Bhatia V, Sreenivas V, Khanal S, Panda SK (2009) Efficacy of l-ornithine l-aspartate in acute liver failure: a double-blind, randomized, placebo-controlled study

showed that low serum vitamin B 12 levels were observed in individuals taking metformin at doses over 2000 mg/day, and a prevalence of mild neuropathy reaching 22.3% in the metformin-users group compared to 15.1% in the non-metformin users group, consistent with the results of previous studies in the literature [49]

Metabolic signals such as ghrelin, insulin or glucagon modulate insulin sensitivity, glucose tolerance, lipid metabolism, vascular hemostasis, and even immune responses 120,121

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