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Bhatt DL, Steg PG, Miller M, et al

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Blood glucose levels rise as the result of a combination of glucose-sparing and diabetogenic effects

Unlike most vitamins, B12 has a uniquely complex absorption pathway: Stomach acid and pepsin release B12 from food proteins B12 binds to R-proteins (haptocorrins) in saliva and stomach Pancreatic enzymes release B12 from R-proteins in the small intestine B12 binds to intrinsic factor (produced by gastric parietal cells) The B12-intrinsic factor complex is absorbed in the terminal ileum A breakdown at any of these five steps causes deficiency which is why B12 deficiency is far more common than dietary intake alone would predict