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Without coenzyme B12, tetrahydrofolate cannot be produced from 5-methyl tetrahydrofolate leading to folate deficiency

While this effect appears to be related to the magnitude and rapidity of glucose lowering rather than a direct effect of the medication itself, patients with a history of diabetic retinopathy should undergo careful ophthalmologic evaluation before and during treatment, and the potential risks should be weighed against the expected benefits of improved glycemic control

World Journal of Gastroenterology

The thin-walled design improves flow rate and patient comfort for the multi-puncture micro-droplet technique

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Also, if you notice any skin condition changes, contact your doctor