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This escalation principle is consistent across the GLP-1 agonist class

( Unfortunately, this symptom of B12 deficiency overlaps with symptoms related to diabetic neuropathy nerve damage caused by high blood sugar that can cause pain and numbness in the extremities ( People with diabetes taking metformin are at a higher risk of developing B12 deficiency because this medication can reduce vitamin B12 absorption in the body ( So, a B12 deficiency could be misdiagnosed as peripheral neuropathy in people with diabetes

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