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David It doesnt matter

Elevated levels of MMA indicate that you aren't getting enough B12 into your body, regardless of what your serum B12 levels say

It can also help break weight plateaus caused by metabolic resistance

Read: PPBS Test: 3 Practices That Affect Your Results Visit your diabetes care team as advised as each consultation helps monitor your progress and determine whether any changes to your treatment plan are needed I think my gestational diabetes was well-managed because the doctor and educators kept such a close watch on my diet, exercise and blood sugar levels

A 5 mg to 10 mg dose injected prior to exercise is standard for maximizing this metabolic adaptation

A less desirable option is to record the surgeons request in the documentation of the block itself