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Cyanocobalamin requires conversion in the body to the active form of Vitamin B12, which might not be efficient in individuals with absorption issues
Check out this article by Jessie Stephens in Australian website MamaMia, where she describes a phone conversation she had with her sister: Im freaking out

Homocysteine inhibits pro-insulin receptor cleavage and causes insulin resistance via protein cysteine-homocysteinylation
