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That number has increased by a third in a decade, attributed, as the ADA says, to the increased prevalence of diabetes and the increased cost per person with diabetes. One in every four dollars spent on health care in this country goes to treating diabetes and its complications

Deficiency can occur due to low dietary intake, especially in vegans, digestive problems, lack of intrinsic factor, certain medications, or age-related absorption decline

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Succinylacetone is also a potent inhibitor of -aminolevulinic acid dehydratase (also called porphobilinogen synthase) leading to accumulation of -aminolevulinic acid (ALA)