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As a general clinical principle: Retest HbA1c no sooner than three months after commencing B12 replacement therapy, and ideally once haematological recovery has been confirmed Confirm haematological recovery normalisation of MCV and haemoglobin before interpreting the repeat HbA1c as reliable Use interim glucose monitoring such as fasting plasma glucose, OGTT, or self-monitored blood glucose (SMBG) to assess glycaemic control during the treatment period

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The practical difference for most people is minimal, though methylcobalamin skips the conversion step and may be preferable for individuals with certain genetic variations affecting B12 metabolism

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