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According to OBRA, the use of antidiabetic medications should include monitoring (e.g., periodic blood glucose) for effectiveness based on desired goals for that individual and to identify complications of treatment such as hypoglycemia or impaired renal function

Tingling feeling in the hands and/or feet and legs Physical weakness Mobility and balance problems, especially problems with walking Personality changes, depression, dementia, and (rarely) psychosis Lack of appetite and constipation Weight loss Anemia is related to B12 deficiency , too, although not all anemias are caused by lack of B12 and B12 deficiency can appear on its own without anemia

It is worth noting that isolated, mildly elevated B12 in an otherwise well person taking supplements typically requires no urgent action beyond stopping non-prescribed supplementation and rechecking levels after an appropriate interval (usually 8-12 weeks)

A lighter, leaner body may reach similar exposure at fewer milligrams while showing a larger heart-rate response