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For people managing prediabetes or metabolic health this enzyme inhibition produces meaningful blood sugar flattening taken 20 to 30 minutes before meals

Vitamin B12 deficiency nerve damage may be relevant

Trying to adjust the dose on your own might make the medication less effective or cause other problems

If B12 doesnt convert your food into glucose, your body may not get the adequate energy it requires

Other contributing factors include: Small intestinal bacterial overgrowth (SIBO) Gastrointestinal infections or parasites Certain medicines that slow digestion (e.g., opioids, anticholinergics, tricyclic antidepressants, GLP-1 receptor agonists) Food intolerances or malabsorption disorders Swallowing excess air (aerophagia) Consumption of carbonated beverages Understanding the underlying cause is essential for effective management

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