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23 Supplementation of 1 mg daily is recommended for patients with specific risk factors (e.g., bariatric/gastric surgery patients, those with severe malnutrition, chronic alcohol use, chronic hemolytic anemia and conditions with high cell turnover, and use of antimetabolite medications such as methotrexate)
This offers a more convenient option for patients who prefer to avoid injections, while still supporting metabolic pathways under medical guidance
The key principle is that any combination therapy should be initiated and monitored under close medical supervision, with dose adjustments made based on glucose monitoring results and individual patient response