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Given that the status of these micronutrients in patients with T2DM is already likely to be suboptimal and that these deficiencies are variously associated with diabetic complications such as compromised endothelial, microvascular, vascular and neurological function, 38,43,4649,80,85,9597 it may be appropriate to consider supplementation where appropriate to mitigate these negative impacts of metformin

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Current treatment options include global immunosuppression, immune-depleting antibodies, and anti-cytokine therapies

J Immunol (2001) 167(9):54649