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DAN can impact various organ systems, including the cardiovascular, gastrointestinal, genitourinary, and sudomotor systems, leading to significant morbidity and mortality among diabetes patients

One very small study found that people who used semaglutide had lower B12 levels, but these patients also had bariatric surgery prior to using semaglutideso its hard to say if using semaglutide would lead to a B12 deficiency, requiring additional B12

Many people who suffer from low energy, fatigue, and headaches turn to B12 supplements, often in the form of daily pills

though it seems to head that way over time means that it can progress really slowly - years and even decades for the absorption problem to formally manifest as a full blown deficiency