scholarly journals Metformin Use and Vitamin B12 Deficiency in Patients with Type-2 Diabetes Mellitus

2016 ◽  
Vol 3 (1) ◽  
pp. 67 ◽  
Author(s):  
Singh Jeetendra ◽  
Baheti Tushar
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Megaloblastic Anemia ◽  
Serum Vitamin ◽  
Cost Effective ◽  
Vitamin B ◽  
Average Dose ◽  
Annual Screening

Metformin is commonly used oral hypoglycaemic agent in the treatment of type-2 Diabetes Mellitus (DM). One of the important side effect of long term metformin therapy is malabsorption of vitamin B<sub>12</sub> which could lead to megaloblastic anemia and peripheral neuropathy. Therefore annual screening of serum vitamin B<sub>12</sub> level or serum methylmalonic acid (MMA)/serum homocysteine level should be done in cases taking metformin for more than four to five years with average dose of &gt;1g per day, even in the absence of haematological or neurological abnormalities. However, as the incidence of type-2 DM is increasing, cost of annual measurement of vitamin B<sub>12</sub> level also increases. Considering cost factor for annual screening, vitamin B<sub>12</sub> supplementation appears to be more cost effective approach rather than annual screening for routine prophylaxis. Routine vitamin preparations available in the market may contain less amount of B<sub>12</sub> and hence are not of much therapeutic use in treatment of B<sub>12</sub> deficiency due to Metformin. Hence there is a need to look for higher doses of approximately 500-2000μg/day.

scholarly journals Economic evaluation of population-based type 2 diabetes mellitus screening at different healthcare settings in Vietnam

PLoS ONE ◽  
2021 ◽  
Vol 16 (12) ◽  
pp. e0261231
Author(s):  
Phung Lam Toi ◽  
Olivia Wu ◽  
Montarat Thavorncharoensap ◽  
Varalak Srinonprasert ◽  
Thunyarat Anothaisintawee ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Cost Effectiveness ◽  
Cost Effective ◽  
Economic Evaluations ◽  
Value For Money ◽  
Healthcare Settings ◽  
Annual Screening

Introduction Few economic evaluations have assessed the cost-effectiveness of screening type-2 diabetes mellitus (T2DM) in different healthcare settings. This study aims to evaluate the value for money of various T2DM screening strategies in Vietnam. Methods A decision analytical model was constructed to compare costs and quality-adjusted life years (QALYs) of T2DM screening in different health care settings, including (1) screening at commune health station (CHS) and (2) screening at district health center (DHC), with no screening as the current practice. We further explored the costs and QALYs of different initial screening ages and different screening intervals. Cost and utility data were obtained by primary data collection in Vietnam. Incremental cost-effectiveness ratios were calculated from societal and payer perspectives, while uncertainty analysis was performed to explore parameter uncertainties. Results Annual T2DM screening at either CHS or DHC was cost-effective in Vietnam, from both societal and payer perspectives. Annual screening at CHS was found as the best screening strategy in terms of value for money. From a societal perspective, annual screening at CHS from initial age of 40 years was associated with 0.40 QALYs gained while saving US$ 186.21. Meanwhile, one-off screening was not cost-effective when screening for people younger than 35 years old at both CHS and DHC. Conclusions T2DM screening should be included in the Vietnamese health benefits package, and annual screening at either CHS or DHC is recommended.

scholarly journals Prevalence of vitamin B12 deficiency among metformin-treated type 2 diabetic patients in a tertiary institution, South-South Nigeria

2019 ◽  
Vol 7 ◽  
pp. 205031211985343
Author(s):  
Sampson Omagbemi Owhin ◽  
Tomisin Mathew Adaja ◽  
Olumuyiwa John Fasipe ◽  
Peter Ehizokhale Akhideno ◽  
Olufunto Olufela Kalejaiye ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Serum Vitamin ◽  
Normal Serum ◽  
Diabetic Patients ◽  
Vitamin B ◽  
Tertiary Institution ◽  
Type 2 Diabetic Patients

Background: The risk of chronic metformin pharmacotherapy to cause vitamin B12 deficiency and its associated medical complications has been of immense concern among diabetic patients. Some studies have postulated that vitamin B12 deficiency is highly prevalent among chronic metformin-treated adult diabetic patients. Aim: This study aimed to determine the prevalence of vitamin B12 deficiency among metformin-treated and metformin-naïve type 2 diabetes mellitus patients. Materials and methods: This was a case-control, prospective, analytical, observational study of 200 adult participants (100 per group) attending the Endocrinology, Medical Out-patients Clinic of Irrua Specialist Teaching Hospital, Irrua, Edo State, Nigeria. The participants’ serum vitamin B12 levels were determined using an immunoassay technique. Data were presented using tables and charts. Chi-square test was used to compare non-continuous proportional variables. Results: The prevalence of vitamin B12 deficiency was 41% and 20% among metformin-treated and metformin-naïve type 2 diabetes mellitus groups, respectively (p = 0.001). Borderline vitamin B12 status was present among 59% of metformin-treated group and 80% of metformin-naïve group (p = 0.001). Neither metformin-treated nor metformin-naïve groups had normal serum vitamin B12 levels. Conclusion: The prevalence of vitamin B12 deficiency was significantly high in diabetics, especially the metformin-treated patients. We advocate for vitamin B12 supplementation among this group of patients in order to prevent the occurrence of vitamin B12 deficiency complications such as macro-ovalocytic anemia, impaired immunity with hypersegmented neutrophils, peripheral neuropathy and subacute degeneration of the spinal cord.

scholarly journals Low levels of serum Vitamin D in chronic periodontitis patients with type 2 diabetes mellitus: A hospital-based cross-sectional clinical study

2015 ◽  
Vol 0 (0) ◽  
pp. 0
Author(s):  
Rosamma Joseph ◽  
AmolVijay Nagrale ◽  
ManaloorGeorge Joseraj ◽  
Kotha Kumar ◽  
JaishidAhadal Kaziyarakath ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Vitamin D ◽  
Type 2 Diabetes Mellitus ◽  
Clinical Study ◽  
Serum Vitamin ◽  
Cross Sectional ◽  
Serum Vitamin D ◽  
Low Levels

scholarly journals Low levels of serum Vitamin D in chronic periodontitis patients with type 2 diabetes mellitus: A hospital-based cross-sectional clinical study

2015 ◽  
Vol 19 (5) ◽  
pp. 501 ◽  
Author(s):  
Rosamma Joseph ◽  
AmolVijay Nagrale ◽  
ManaloorGeorge Joseraj ◽  
KothaMuttathu Pradeep Kumar ◽  
JaishidAhadal Kaziyarakath ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Vitamin D ◽  
Type 2 Diabetes Mellitus ◽  
Clinical Study ◽  
Serum Vitamin ◽  
Cross Sectional ◽  
Serum Vitamin D ◽  
Low Levels

STUDY OF SERUM VITAMIN-D IN TYPE-2 DIABETES MELLITUS PATIENTS.

2021 ◽  
pp. 187-188
Author(s):  
Ajay Jain ◽  
Debina sarkar ◽  
G.G. Kaushik ◽  
Ankita Sharma
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Vitamin D ◽  
Type 2 Diabetes Mellitus ◽  
Blood Sugar ◽  
Healthy Subjects ◽  
Serum Vitamin ◽  
Serum Vitamin D ◽  
Type 2 Diabetic

Background: Type-2 diabetes mellitus (T2DM) is a progressive and chronic disease characterized by both β-cell dysfunction and increased insulin resistance. Diabetes mellitus is now considered a giant killer disease of the 21st century with its vicious prongs in the South-East Asian countries, specially India, which is rightly said to be the ''Diabetes Capital'' of the world. Vitamin D has important effects on insulin action, and may impact on a number of pathways which may be of importance in the development of type 2 diabetes mellitus. Materials & Methods: In this study 62 Type-2 diabetic patients, 62 healthy controls were enrolled. Biochemical analytes measured were Serum glucose (Fasting Blood Sugar & Post Prandial Blood Sugar), Glycosylated Haemoglobin, Serum Vitamin-D. Results: The mean Serum Vitamin-D in Type-2 diabetic subjects were (16.3 ±3.0) while in healthy subjects(controls) the values were (39.3±5.2) respectively. These values were found to be statistically highly signicant(p<0.001). Conclusion: Serum Vitamin-D levels were decreased in Type 2 diabetic subjects as compared to the values in healthy subjects(controls).

scholarly journals A systematic review of economic evaluations in non-insulin antidiabetic treatments for patients with type 2 diabetes mellitus

2019 ◽  
Vol 2019 ◽  
pp. 228424031987657 ◽  
Author(s):  
Néboa Zozaya ◽  
Margarita Capel ◽  
Susana Simón ◽  
Alfonso Soto-González
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Management Strategies ◽  
Cost Effective ◽  
Cost Utility ◽  
Economic Evaluations ◽  
Life Years ◽  
Comparative Results

The approval of new non-insulin treatments has broadened the therapeutic arsenal, but it has also increased the complexity of choice for the treatment of type 2 diabetes mellitus (DM2). The objective of this study was to systematically review the literature on economic evaluations associated with non-insulin antidiabetic drugs (NIADs) for DM2. We searched in Medline, IBECS, Doyma and SciELO databases for full economic evaluations of NIADs in adults with DM2 applied after the failure of the first line of pharmacological treatment, published between 2010 and 2017, focusing on studies that incorporated quality-adjusted life years (QALYs). The review included a total of 57 studies, in which 134 comparisons were made between NIADs. Under an acceptability threshold of 25,000 euros per QALY gained, iSLGT-2 were preferable to iDPP-4 and sulfonylureas in terms of incremental cost-utility. By contrast, there were no conclusive comparative results for the other two new NIAD groups (GLP-1 and iDPP-4). The heterogeneity of the studies’ methodologies and results hindered our ability to determine under what specific clinical assumptions some NIADs would be more cost-effective than others. Economic evaluations of healthcare should be used as part of the decision-making process, so multifactorial therapeutic management strategies should be established based on the patients’ clinical characteristics and preferences as principal criteria.

scholarly journals Health Economic Evaluation of Type 2 Diabetes Mellitus: A Clinical Practice Focused Review

2015 ◽  
Vol 8 ◽  
pp. CMED.S20906 ◽  
Author(s):  
Andreas Liebl ◽  
Kamlesh Khunti ◽  
Domingo Orozco-Beltran ◽  
Jean-Francois Yale
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Health Economic ◽  
Type 2 Diabetes Mellitus ◽  
Drug Therapy ◽  
Glycemic Control ◽  
Cost Effective ◽  
Treatment Intensification ◽  
Total Cost

Type 2 diabetes mellitus (T2D) is a growing healthcare burden primarily due to long-term complications. Strict glycemic control helps in preventing complications, and early introduction of insulin may be more cost-effective than maintaining patients on multiple oral agents. This is an expert opinion review based on English peer-reviewed articles (2000–2012) to discuss the health economic consequences of T2D treatment intensification. T2D costs are driven by inpatient care for treatment of diabetes complications (40%–60% of total cost), with drug therapy for glycemic control representing 18% of the total cost. Insulin therapy provides the most improved glycemic control and reduction of complications, although hypoglycemia and weight gain may occur. Early treatment intensification with insulin analogs in patients with poor glycemic control appears to be cost-effective and improves clinical outcomes. Key Messages • Type 2 diabetes mellitus is a growing burden on healthcare services. • Despite the high cost of drug therapy versus diet and lifestyle interventions, treatment intensification with insulin analog therapy is a cost-effective strategy for improving clinical outcomes in patients with poor glycemic control.

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