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If the deficiency is detected, metformin can be continued while the deficiency is corrected with B 12 supplements

Researchers have extensively studied NNMT due to observations linking elevated NNMT activity with changes in adipose tissue biology, metabolic efficiency, and energy regulation

Clodfelter KH, Holloway MG, Hodor P, Park SH, Ray WJ, Waxman DJ

[35] Cardiometabolic disease outcomes [edit] Multiple studies have explored the association between vitamin B 12 and metabolic disease outcomes, such as obesity, insulin resistance and the development of cardiovascular disease