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This incident offers a vital lesson: the green list framework cannot be treated as a static, self-policing registry

6.1 Exposure of the intestine to bacterial enzymes degrading thiamine or producing thiamine antagonists Abnormal proliferation of gut bacteria in the upper small intestine, defined by the term small intestinal bacterial overgrowth (SIBO), is associated with symptoms such as bloating, abdominal pain, excessive foul-smelling flatulence, constipation and/or diarrhea

:contentReference[oaicite:10] If additional glycemic control is needed, clinicians may increase further per label guidance and clinical judgment

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