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This resistance is mediated by different causes and mechanisms, (that are resumed in Table 1 and excellently summarized in different review articles [78].One of the most obvious and intriguing mechanisms of resistance involves alteration in CD38 expression, a crucial factor in both primary and acquired resistance to anti-CD38 therapies

Abbreviations DPPOS: Diabetes Prevention Program Outcomes Study GWAS: Genome-wide association study IF: Intrinsic factor MHRA: Medicines and Healthcare products Regulatory Agency PPI: Proton pump inhibitor QC: Quality control UKB: UK Biobank References Kim J, Ahn CW, Fang S, Lee HS, Park JS (2019) Association between metformin dose and vitamin B12 deficiency in patients with type 2 diabetes