Guidelines

Canadian adult guidance limits sedentary time to 8 hours or less per day and recreational screen time to no more than 3 hours per day. The WHO physical activity benchmark is at least 150 minutes of moderate-to-vigorous exercise per week. Existing guidelines do not provide detailed population-specific protocols for reducing sedentary behaviour with digital health tools. Before 2022, the UK lacked official guidance specifically for management or monitoring of metformin-associated B12 deficiency. For systemic sclerosis-associated ILD, glucocorticoids are strongly advised against because of systemic sclerosis renal crisis risk. Several guidelines recognise long-term metformin use as an established risk factor for vitamin B12 deficiency. The 2022 MHRA safety alert recommended B12 testing in metformin-treated people with symptoms suggestive of deficiency. The 2022 MHRA alert also recommended checking B12 levels during annual review bloods for metformin-treated patients with risk factors, especially long-term users.