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Integration: Optimize diabetes control first (6-12 months achieving target HbA1c)

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Metformin, proton pump inhibitors, and H2 blockers are common medications linked to vitamin B12 deficiency also [1,2]

Some people notice hollowing of the cheeks or temples, deeper folds, looser skin around the jawline, or a more tired appearance

10.1038/s41598-020-61933-z 10 AnisieiA.OanceaF.MarinL

nevertheless, parenteral doses within the Dietary Reference Intake (11-12 mg elemental zinc/day) are not expected to pose teratogenic risk, whereas severe maternal deficiency correlates with pre-term birth