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Presented for research literature review only Sumithran P et al

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HR 1.19, 95% CI 0.91.58), but not for the other DPP-4 inhibitors as in the TECOS study for sitagliptin (HR 1.00, 95% CI 0.831.20) or the CARMELINA study for linagliptin (HR 0.90, 95% CI 0.741.08) (57, 62, 64, 65, 68)

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Nutritional imbalances, including low B12 levels, are becoming increasingly common due to: Highly processed diets Use of acid-reducing medications Digestive disorders (like IBS or celiac disease) Vegetarian or vegan diets without proper supplementation In suburban communities like Troy, MI, where fast-paced lifestyles often limit dietary variety, its easy to overlook vitamin levels until symptoms appear

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