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278,279 Lifestyle interventions, particularly aerobic exercise, have also demonstrated benefits in enhancing mitochondrial biogenesis and function, offering a non-pharmacological approach to managing DPN (Fig

The Methylmalonyl-CoA Reaction: B12 is also needed by another enzyme (methylmalonyl-CoA mutase) inside the cells power plants (mitochondria)

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These differences are indicative of increased lipid synthesis and enhanced inflammation in individuals with B12 deficiency which may contribute to adipose dysfunction often observed in obesity

Moderate protein intake (1.6-2.2 g/kg body weight) supports muscle preservation while in a deficit