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Evidence-based guidance supports polyethylene glycol (PEG) for constipation

In these groups of patients with risk factors who are taking metformin, especially over the long term, the new MHRA guidance suggests we should consider checking vitamin B12 levels as part of annual review bloods this is a significant change to current typical practice

A further possibility is that the positive chronotropic effect could be, at least partially, mediated by sympathetic nervous system enhancement, related to the inhibition of the autonomic nervous system [18, 36, 37]