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Standard titration schedule The established titration protocol, based on clinical trials including the landmark STEP 1 study, follows this progression

Also, while the manufacturers of metformin recommend against breastfeeding while taking the drug, data have shown that metformin is excreted into breast milk in small amounts and adverse effects on infant plasma glucose have not been reported in human studies

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Complex cases without obvious bulging may need specialist evaluation with advanced imaging

For healthy UK adults, the Reference Nutrient Intake is 1.5 micrograms daily, easily obtained through diet