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Whilst stopping Rybelsus cold turkey will not typically cause immediate harm, doing so without medical supervision and an alternative diabetes management strategy can lead to: Deteriorating glycaemic control with HbA1c levels rising over subsequent weeks and months Increased risk of diabetes-related complications if hyperglycaemia becomes persistent Worsening of blood glucose control which may require additional monitoring and medication adjustments Cardiovascular risk associated with poorly controlled diabetes The MHRA and NICE diabetes guidelines (NG28) emphasise that any changes to diabetes medication should be discussed with your healthcare team

B12 Deficiency: Primary reason is vitamin B12 deficiency, starting with a dosage of 30mcg

(2018) Int J Mol Sci