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There is an extensive literature based on data from pre-clinical and clinical studies that indicates metformin protects endothelial function from the effects of diabetes (33)

A patient presenting with vitamin B12 deficiency after total gastrectomy: the primary code captures the nutritional deficiency (E53.8), while Z90.3 documents the underlying anatomical cause relevant to payer and care management context

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Nausea, vomiting, abdominal pain, loss of appetite, diarrhea, or constipation may occur