scholarly journals Vitamin B12 deficiency among vegetarian and non-vegetarian diabetic population receiving prolonged Metformin based oral hypoglycemic agents therapy

2017 ◽  
Vol 4 (4) ◽  
pp. 1150 ◽  
Author(s):  
Vivek Kumar Verma ◽  
Ranjit Kumar Nim ◽  
P. S. Singh ◽  
Manoj Kumar ◽  
Geeta Singh ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Vitamin B12 ◽  
Vitamin B12 Deficiency ◽  
Animal Origin ◽  
P Value ◽  
Vitamin B ◽  
B12 Deficiency ◽  
Diabetic Population ◽  
Vitamin B 12 ◽  
Diabetes Patients

Background: Diabetes is a group of metabolic disorder that share the phenotype of hyperglycemia. Over the period of time the metabolic dysregulation associated with diabetes mellitus causes secondary pathophysiological changes in multiple organs like heart, blood vessels, eyes, kidney and nerves resulting in various complications. However, a common potential interaction of metformin with vitamin B-12 is well documented but is poorly studied by the physicians who prescribe metformin to their diabetic patients. Since vitamin B-12 deficiency is common among vegan population as compared to population consuming food of animal origin (meat, fish and dairy products). But in this article, it has been studied that metformin cause vitamin B-12 deficiency even in non-vegetarian population. The aim of this study was to asses’ vitamin B12 deficiency among vegetarian and non-vegetarian diabetic population receiving prolonged Metformin based oral hypoglycaemic agents therapy. It was a cross sectional study done in Department of Medicine, UPUMS, Saifai, Etawah, Uttar Pradesh, India.Methods: Study done among patients of type 2 diabetes mellitus of age group 30-60 years on prolonged metformin based OHA therapy and having peripheral neuropathy were included in study. Data was analysed on SPSS Version 22.0 and p value obtained.Results: Statistical analysis of 93 patients included in study showed that vitamin B12 deficiency is common among the vegetarian (56.52%) and non-vegetarian (35.71%) population but the difference is not statistically significant (p value=0.29) which is more in favour of metformin associated vitamin B12 deficiency in non-vegetarian population.Conclusions: Vitamin B12 deficiency is common in diabetes patients on metformin based OHA therapy hence we recommend routine screening for Vitamin B12 deficiency in such diabetes patients. 

Frequency of Vitamin B12 Deficiency in Pregnant Women with Gestational Diabetes Mellitus

2021 ◽  
Vol 15 (10) ◽  
pp. 2753-2755
Author(s):  
Shazia Jamil ◽  
Naveed Mahmood ◽  
Israr-ul- Haque ◽  
Rabiah Haque ◽  
Muhammad Imran-ul-Hasan ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Gestational Diabetes ◽  
Gestational Diabetes Mellitus ◽  
Vitamin B12 ◽  
Pregnant Women ◽  
Vitamin B12 Deficiency ◽  
Group I ◽  
B12 Deficiency ◽  
Vitamin B 12 ◽  
Group Ii

Objective: To determine the prevalence of vitamin B-12 deficiency in pregnant women with gestational diabetes mellitus. Study Design: Retrospective study Place and Duration of Study: Department of Medicine, OMC Hospital, Jail Road Lahore from January, 2020 to December, 2020. Methods: Two hundred and thirty pregnant females were enrolled age between 18-45 years. Detailed demographics of enrolled cases age, gestational age, gravidity and body mass index were recorded after taking informed written consent. Among 230 cases, 100 women were non GDM (group I) and 130 had gestational diabetes mellitus (group II). Blood samples were taken from all the patients for measuring vitamin B12 status. Vitamin B12 was defined as <300 pg/ml. Results: Mean age of the patients in group I was 31.64±7.45 years with mean BMI 25.88±8.65 kg/m2 while mean age among GDM group was 34.55±5.71 years with mean BMI 27.36±9.44 kg/m2. Mean gestational age in group I was 33.72±4.21 weeks and in group II 35.08±9.27 weeks. In group I 20 (20%) had vitamin B12 deficiency and in group II rate ofvitamin B12 deficiency was high among 90 (69.2%) cases. We found a significantly relation between vitamin B12 and GDM with p value <0.0007. Conclusion: The prevalence of vitamin B-12 deficiency among pregnant women of gestational diabetes mellitus was significantly high as compared to normal pregnant women. Keywords: Pregnant Women, Gestational Diabetes Mellitus, Vitamin B12 deficiency

scholarly journals Homocystinuria masquerading as vitamin B12 deficiency

2012 ◽  
Vol 4 (2) ◽  
pp. 326-328
Author(s):  
M Wadhwani ◽  
S Beri ◽  
A Saili ◽  
S Garg
Keyword(s):  
Vitamin B12 ◽  
Megaloblastic Anemia ◽  
Vitamin B12 Deficiency ◽  
Interesting Case ◽  
Vitamin B ◽  
Ophthalmological Examination ◽  
Ophthalmic Manifestations ◽  
History Of ◽  
B12 Deficiency ◽  
Vitamin B 12

Background: Homocystinuria is a rare metabolic disorder charcterised by excess homocysteine in the urine. Vitamin B12 deficiency has diverse cutaneous, nervous and ophthalmic manifestations. Objective: To report a case of homocystinuria masquerading as vitamin B 12 deficiency. Case: We hereby are presenting an interesting case of a 4 year old boy who was being treated for Vitamin B 12 deficiency on the basis of history of delayed milestone, abdominal pain and hyperpigmentation of skin which was diagnosed as homocystinuria. Conclusion: It is important to carry out ophthalmological examination in every case of megaloblastic anemia if associated with blurring of vision and mental retardation.DOI: http://dx.doi.org/10.3126/nepjoph.v4i2.6554 Nepal J Ophthalmol 2012; 4 (8): 326-328

scholarly journals Vitamin B 12 Assay – are we on Track?

2020 ◽  
Vol 2 (8) ◽  
pp. 01-03
Author(s):  
Rateesh Sareen
Keyword(s):  
Vitamin B12 ◽  
Vitamin B12 Deficiency ◽  
Reference Interval ◽  
Population Characteristics ◽  
Vitamin B ◽  
B12 Deficiency ◽  
Vitamin B 12 ◽  
Work Up

Vitamin B12 assay is one of the most frequently ordered tests particularly as a part of regular medical checkups. The deficiency is rampant in vegetarian population. It is of immense importance that laboratories establish their own reference interval (RI) of analyte specially Vitamin B12 as a diagnosis of Vitamin B12 deficiency based on RI of kit insert inadvertently leads to unnecessary treatment or work up. A blind reliance on RI of kit insert should be discouraged as they do not take into account population characteristics and do not truly reflect RI specific to the population under study.

scholarly journals OVERCOMING VITAMIN B12 DEFICIENCY IN VEGAN DIET

2014 ◽  
Vol 04 (01) ◽  
pp. 104-105
Author(s):  
Prassanna Baby ◽  
Keyword(s):  
Vitamin B12 ◽  
Higher Plants ◽  
Vitamin B12 Deficiency ◽  
Vegan Diet ◽  
Vitamin B ◽  
Daily Diet ◽  
B12 Deficiency ◽  
Vitamin B 12 ◽  
Micro Organisms ◽  
Dietary Deficiency

Abstract:Vitamin B12 is a crystalline compound essential to a number of micro-organisms and animals, including humans. So far as is known it is not present in higher plants. Pure vegetarian food is nearly free from vit. B12. It is a nutrient that needs attention in vegan diet. Vegetarians are at risk for vitamin B(12) (B12) deficiency due to suboptimal intake. Dietary deficiency of vitamin B12 due to vegetarianism is increasing and causes hyperhomocysteinemia Areas for research include intermittent vitamin B12 supplement dosing and better measurements of the bioavailability of B12 in fermented vegetarian foods and algae. The goal of the present literature review was to create an awareness among the vegans to identify the vegetarian sources of Vitamin B12 and to incorporate them into their daily diet.

scholarly journals Défice de Vitamina B12 na Diabetes Mellitus Tipo 2

2017 ◽  
Vol 30 (10) ◽  
pp. 719
Author(s):  
Carlos Tavares Bello ◽  
Ricardo Miguel Capitão ◽  
João Sequeira Duarte ◽  
Jorge Azinheira ◽  
Carlos Vasconcelos
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Vitamin B12 ◽  
Vitamin B12 Deficiency ◽  
Common Disease ◽  
High Prevalence ◽  
B12 Deficiency ◽  
Diabetic Population

Introduction: Type 2 diabetes mellitus is a common disease, affecting up to 13.1% of the Portuguese population. In addition to the known micro and macrovascular complications, drug side effects constitute a major concern, leading to changes in the treatment guidelines, which favor safety over efficacy. Metformin is the first-line pharmacological treatment for most patients with type 2 diabetes mellitus; however, it has been associated with vitamin B12 deficiency in up to 30% of treated patients. The authors describe the prevalence of vitamin B12 deficiency in a diabetic population and explore the possible underlying factors.Material and Methods: Retrospective, observational study. Clinical and laboratory data of type 2 diabetes mellitus patients whose vitamin B12 status was evaluated in the last decade (2005 - 2016) were analyzed. Patients with known malabsorptive syndromes or having undergone bariatric surgery were excluded from the study. Statistical analysis of the data was done and the results were considered statistically significant at p values < 0.05.Results: The study included a total of 1007 patients (58% women) with a mean age of 66.4 ± 12.2 years and 11 ± 10.4 years of type 2 diabetes mellitus duration. These patients had a high prevalence of complications: diabetic renal disease 47.7%, neuropathy 9.2%, retinopathy 14.9%, coronary artery disease 8.4%, cerebrovascular disease 10.9%, and peripheral arterial disease 5.5%. Vitamin B12 deficiency (< 174 ng / dL) was present in 21.4% of the population and this subgroup was older (68.4 vs 65.8 years, p = 0.006), had a longer type 2 diabetes mellitus duration (13.35 vs 10.36 years; p = 0.001), higher prevalence of retinopathy (20.9% vs 13.3%; p = 0.005) and thyroid dysfunction (34% vs 23.7%; p = 0.002). Vitamin B12 deficiency was also more frequent in patients treated with metformin (24.7% vs 15.8%; p = 0.017), antiplatelet agents (25.4% vs 16.2%, p < 0.001), and calcium channel blockers (26.8% vs 18.2%; p = 0.001). After adjustment for possible confounders, the variables associated with B12 deficiency were: metformin, hypothyroidism, age and type 2 diabetes mellitus duration.Discussion: Despite the retrospective design, the results report a high prevalence of vitamin B12 deficiency in the type 2 diabetic population. This study also demonstrates that the B12 deficiency risk is higher in older people, with longer diabetes mellitus duration, hypothyroidism and treated with metformin.Conclusion: Further studies are needed to identify the risk factors for the B12 deficit. The recognition of these variables will contribute to optimize the screening and prevention of the B12 deficiency in type 2 diabetes mellitus.

scholarly journals KNUCKLE HYPERPIGMENTATION AS A PRELIMINARY MARKER OF VITAMIN B 12 DEFICIENCY: A CASE SERIES

2021 ◽  
pp. 36-38
Author(s):  
Manali Patil ◽  
S. N. Agrawal ◽  
V. V. Saoji
Keyword(s):  
Vitamin B12 ◽  
Megaloblastic Anemia ◽  
Case Series ◽  
Vitamin B12 Deficiency ◽  
Neurological Deficits ◽  
Vitamin B ◽  
Important Clue ◽  
B12 Deficiency ◽  
Systemic Manifestations ◽  
Vitamin B 12

Vitamin B12 deficiency is common in vegetarian population in India and can present with variable Hematological (megaloblastic anemia), Neuropsychiatric, Mucocutaneous (glossitis, angular stomatitis), Skin (pallor, hyperpigmentation) and Hair changes (dry, brittle, thin, lustreless, prematurely grey). Knuckle hyperpigmentation has been described in vitamin B12 deficiency but usually these patients are dermatologically asymptomatic but they have systemic manifestations like megaloblastic anemia, pancytopenia or neurological deficits. The foreground of this study is highlighting the importance of knuckle hyperpigmentation as an early cutaneous sign of vitamin B12 deficiency which points an important clue towards the aetiology of Megaloblastic anemia.

scholarly journals Pancytopenia in pregnant patients with COVID-19 infection and vitamin B12 deficiency: a case report study

2021 ◽  
Vol 4 (Special2) ◽  
pp. 415-418
Author(s):  
Neha Agarwal ◽  
Neha Khatri ◽  
Preeti Singh
Keyword(s):  
Folic Acid ◽  
Vitamin B12 ◽  
Vitamin B12 Deficiency ◽  
Vitamin B ◽  
Case Presentation ◽  
B12 Deficiency ◽  
Vitamin B 12 ◽  
Folate And Vitamin B12 ◽  
Vitamin B12 Supplementation ◽  
In Pregnancy

Background: Folate and vitamin B 12 deficiency can lead to pancytopenia in pregnancy. Some cases of pancytopenia due to COVID-19 infection have also been reported. The two cases that we present are related to the coincidence of pregnancy and deficiency of folic acid and vitamin B12 with COVID-19 infection. Case presentation: A 26-year- woman G3P1L1A1 and 21-year-woman G2P1L1 presented with pancytopenia and mild COVID-19 infection. The antenatal period was uneventful, and both cases also had folate and vitamin B12 deficiency. They received blood products, folic acid, and vitamin B12 supplementation. COVID- 19 infection was managed well with analgesic and vital monitoring. Postpartum hemorrhage occurred in the second case, which was well managed with uterotonics. All laboratory parameters came out to be normal after three months of supplementation of folic acid and vitamin B12. Conclusion: Pancytopenia in pregnancy due to folate and vitamin B12 deficiency and COVID- 19 infection can be easily managed with timely intensive targeted therapy, but we should be extra vigilant while handling such complicated cases, keeping in mind all possible differential diagnoses for pancytopenia.

scholarly journals Frequency of Hypovitaminosis B12 in Pregnant Women with Gestational Diabetes Mellitus

2021 ◽  
Vol 15 (7) ◽  
pp. 2296-2298
Author(s):  
Aesha Sadaf Rizwan ◽  
Kousar Robeen ◽  
Afshan Ahmad ◽  
Irum Batool Hashmi ◽  
Muhammad Tahir ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Gestational Diabetes ◽  
Gestational Diabetes Mellitus ◽  
Vitamin B12 ◽  
Pregnant Women ◽  
Gestational Age ◽  
Vitamin B12 Deficiency ◽  
High Rate ◽  
P Value ◽  
B12 Deficiency

Objective: To determine the frequency of hypovitaminosis B12 in pregnant females presented with gestational diabetes mellitus. Study Design: Retrospective study Place and Duration: The department of Gynaecology and Obstetrics, Category A Hospital, Batkhela Malakand and Muhammad Teaching Hospital, Peshawarfor the duration of six months from October 2020 to March 2021. Methodology: Total 190 pregnant women (95 GDM, 95 non-GDM) were enrolled in this study. Patient’s ages were ranging between 18 to 40 years. Detailed demographics including age, gestational age, body mass index (BMI), and gravidty were recorded after taking informed written consent. Blood samples were taken from all the patients for measuring vitamin B12 status. Hypovitaminosis B12 was defined as <300 pg/ml. Data was analyzed by SPSS 24.0. Results: Mean age of patients was 32.46±6.82 years. Mean BMI was 26.24±2.34 kg/m2. Mean gestational age was 34.56±2.18 weeks. 105 (55.26%) women were multigravida. 80 (42.11%) patients had vitamin B12 level <300 pg/ml. Patients with GDM had high rate of vitaminosis B12 deficiency as compared to non-GDM patients (65.26% Vs 18.95%). A significant association was observed between GDM and hypovitaminosis B12 with p-value <0.0001. Conclusion: Vitamin B12 deficiency was significantly associated with gestational diabetes mellitus with frequency of 65.26%. Keywords: Vitaminosis B12, Gestational Diabetes Mellitus, Pregnancy

scholarly journals A study of anemia in hypothyroidism with reference to vitamin B12 deficiency

2019 ◽  
Vol 6 (5) ◽  
pp. 1667
Author(s):  
Palak Bhuta ◽  
Amit Shah ◽  
Arti Muley
Keyword(s):  
Vitamin B12 ◽  
Symptomatic Relief ◽  
Vitamin B12 Deficiency ◽  
Vitamin B ◽  
B12 Deficiency ◽  
Vitamin B 12 ◽  
Larger Sample ◽  
Hypothyroid Patients ◽  
Prevalence Of Anemia

Background: Hypothyroidism is the most common of thyroid disorders in India. Anemia and hypothyroidism often occur simultaneously. Only few studies have assessed the role of vitamin B12 deficiency in this anemia. So, we planned this study to assess prevalence of anemia in hypothyroidism and to see if there is any association between vitamin B12 deficiency and anemia in these patients.Methods: It was an observational study. All hypothyroid patients attending the medicine OPD or admitted to medicine wards were enrolled for the study. Total 60 patients were included. Data was analyzed to assess the burden of anemia and B12 deficiency in hypothyroid and to find out any correlation between TSH level, anemia and vitamin B12 deficiency.).Results: About one third of hypothyroid had decreased vitamin B 12 levels. TSH level showed significant positive correlation with hemoglobin value. 28% of the hypothyroid patients had vitamin b12 deficiency, but TSH levels itself did not correlate with vitamin B12 level. However, it was seen that those who had combined thyroid and B12 deficiency had significantly higher chances of developing generalized swelling and breathlessness.Conclusions: Although there is no correlation between TSH level and B12 deficiency, it may be helpful to determine B12 level in hypothyroid patients who present with anemia, generalized swelling and/or breathlessness as B12 supplementation may give better symptomatic relief in them as compared to treating with thyroxine alone. More elaborative studies with larger sample size are required to explore this rather unattended relation of anemia in hypothyroidism with B12 deficiency.

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