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Electronic structure calculations show that cyanocobalamin does not interact with three potential substrates that could convert it into a form of vitamin B12 easily absorbed by the human body and capable of participating in the turnover of active vitamin B12 forms

doi: 10.1016/S0893-133X(02)00383-4

This happens through several steps involving the digestive system, liver, and kidneys

Beyond glucose lowering, metformin exerts pleiotropic effects that include endothelial protection, preservation of mitochondrial function, modulation of redox homeostasis, suppression of inflammation, attenuation of fibrosis, and regulation of autophagy (Table 1)