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Vitamin B12 acts as a cofactor for the enzyme methionine synthase, which is crucial for DNA synthesis

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Gong, 2014, "Leveraging melanocortin pathways to treat glomerular diseases", Adv Chronic Kidney Dis 21(2):134-51

Use a new sterile syringe for every step

patient also has comorbid obesity with BMI of 38.2 which is expected to improve with GLP-1 therapy" covers both indications while keeping diabetes as the primary treatment rationale