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OCT1 Expression in adipocytes could contribute to increased metformin action in obese subjects

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suffering from any condition that requires treatment with vitamin B 12 such as pernicious anaemia and strict vegans

That is the evidence gap, stated plainly: the mechanism is well-motivated and the preclinical signal is consistent, but no human study has confirmed that any of it translates to people, at any dose, by any route

Studies suggest it activates lipolysis the process of breaking down stored fat and inhibits lipogenesis, which is the formation of new fat cells