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1,15 Hyperglycemia-induced metabolic pathways Polyol pathway activation In a hyperglycemic state, excess glucose is shunted into the polyol pathway, where aldose reductase catalyzes its reduction to sorbitol, which in turn is oxidized to fructose by sorbitol dehydrogenase

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This is especially beneficial for those who may struggle to get adequate B12 through diet alone, including vegetarians, vegans, or those with certain digestive issues