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The instruments used to perform the procedure have gotten smaller and thinner and the techniques have advanced significantly

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As a general clinical principle: Retest HbA1c no sooner than three months after commencing B12 replacement therapy, and ideally once haematological recovery has been confirmed Confirm haematological recovery normalisation of MCV and haemoglobin before interpreting the repeat HbA1c as reliable Use interim glucose monitoring such as fasting plasma glucose, OGTT, or self-monitored blood glucose (SMBG) to assess glycaemic control during the treatment period