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The biggest change to current clinical practice is likely to be the advice to consider periodic monitoring of B12 levels in patients taking metformin who are at risk of deficiency, which includes a wide range of our patients living with type 2 diabetes
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When symptoms do occur, they may include 7,46,47 : Debilitating fatigue Itching and numbness Headaches Muscle cramps Weight loss Sleep disturbances Lack of appetite Nausea and vomiting Shortness of breath Seizures Edema (swelling) of the extremities CKD is often discovered in people who do not have significant symptoms when they either attend their yearly physical and undergo lab testing or have blood work done for other reasons
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