Increasing Vitamin B12 Screening Among Patients With Type 2 Diabetes on Long-Term Metformin Therapy

2021 ◽  
pp. cd200108
Author(s):  
Elijah P. Mays
Keyword(s):  
Type 2 Diabetes ◽  
Vitamin B12 ◽  
Metformin Therapy ◽  
Vitamin B12 Screening

scholarly journals Prevalence of Vitamin B12 Deficiency In Patients With Type II Diabetes Mellitus On Metformin

2021 ◽  
Vol 5 (1) ◽  
pp. 39-43
Author(s):  
D. Malla ◽  
M.R. Bajracharya ◽  
B.B. Karki ◽  
A.D. Rajouria ◽  
P.S. Shrestha
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Vitamin B12 ◽  
Medical Science ◽  
Vitamin B12 Deficiency ◽  
Cross Sectional ◽  
Metformin Therapy ◽  
B12 Deficiency

Background: Diabetes Mellitus is one of the most encountered disease in our out patient department and metformin is the first drug of choice to treat Diabetes mellitus. As metformin is one of the cheapest drug, many patients use these drug for long period of time with consultation and without consultations with doctors. Patients under long term metformin use are not aware of Vitamin B12 deficiency and its associated signs and symptoms. In Nepal due to poverty, lack of education and awareness on diabetes mellitus we doctors find much difficult to explain patients on the consequences of diseases. So I decided to do this study which could be much easier to explain patients on effect of metformin of vitamin B12 levels and the consequences life style modifications and supplement of Vitamin B12 to the patients. Methods: This is a Cross-Sectional Study done in the patients with Type 2 diabetes were selected based on inclusion and exclusion criteria. Basic biochemical investigation were sent the lab of the National academy of medical science. Serum B12 assay were done. Vitamin B12 deficiency is defined as values <150pg/ml. Association between vitamin B12 deficiency with duration of metformin therapy, duration of diabetes, with age, sex were done. Results: The mean vitamin B12 level is low as the duration of metformin treatment increases. The sex, age relation with development of vitamin B12 deficiency was not significant. In my study out of 210 patients 107 patients were having severe vitamin B12 deficiency level and 63 patients had a borderline Vitamin B12 deficiency level which shows that the deficiency increases as per longer use of metformin, which shows prevalence of 50.95%. Conclusions: Vitamin B12 deficiency occurs in type 2 diabetes mellitus patients treated with long term metformin. The duration of metformin therapy significantly affects the development of vitamin B12 deficiency. As a treating physician we always need to explain our patients about the side effect of metformin and regular follow up and investigations must be done to early diagnosis of vitamin B12 deficiency to improve the quality of life.

Metformin regulates TRPM6, a potential explanation for magnesium imbalance in type 2 diabetes patients

2020 ◽  
Vol 98 (6) ◽  
pp. 400-411 ◽  
Author(s):  
Hacene Bouras ◽  
Sara R. Roig ◽  
Steef Kurstjens ◽  
Cees J.J. Tack ◽  
Mohamed Kebieche ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Cell Surface ◽  
Fine Tuning ◽  
Metformin Treatment ◽  
Long Term Effects ◽  
Short Term ◽  
Metformin Therapy ◽  
Diabetes Patients

Metformin therapy is associated with lower serum magnesium (Mg2+) levels in type 2 diabetes patients. The TRPM6 channel determines the fine-tuning of Mg2+ (re)absorption in intestine and kidney. Therefore, we aimed to investigate the short- and long-term effects of metformin on TRPM6. Patch clamp recordings and biotinylation assays were performed upon 1 h of incubation with metformin in TRPM6-transfected HEK293 cells. Additionally, 24 h of treatment of mDCT15 kidney and hCaco-2 colon cells with metformin was applied to measure the effects on endogenous TRPM6 expression by quantitative real-time PCR. To assess Mg2+ absorption, 25Mg2+ uptake measurements were performed using inductively coupled plasma mass spectrometry. Short-term effects of metformin significantly increased TRPM6 activity and its cell surface trafficking. In contrast, long-term effects significantly decreased TRPM6 mRNA expression and 25Mg2+ uptake. Metformin lowered TRPM6 mRNA levels independently of insulin- and AMPK-mediated pathways. Moreover, in type 2 diabetes patients, metformin therapy was associated with lower plasma Mg2+ concentrations and fractional excretion of Mg2+. Thereby, short-term metformin treatment increases TRPM6 activity explained by enhanced cell surface expression. Conversely, long-term metformin treatment results in downregulation of TRPM6 gene expression in intestine and kidney cells. This long-term effect translated in an inverse correlation between metformin and plasma Mg2+ concentration in type 2 diabetes patients.

scholarly journals EVALUATION OF SERUM VITAMIN B12 LEVELS IN TYPE 2 DIABETES PATIENTS ON METFORMIN THERAPY ATTENDING A TERTIARY CARE HOSPITAL

2017 ◽  
Vol 4 (90) ◽  
pp. 5399-5404
Author(s):  
Anand Kalakappa Koppad ◽  
Gavisiddanagowda Patil ◽  
Basavaraj Devendrappa Baligar ◽  
Varun Bhaktarahalli Renukappa
Keyword(s):  
Type 2 Diabetes ◽  
Vitamin B12 ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Serum Vitamin ◽  
Care Hospital ◽  
Metformin Therapy ◽  
Diabetes Patients

METFORMIN THERAPY AND VITAMIN B12 LEVELS: A CASE CONTROL STUDY

2021 ◽  
pp. 71-72
Author(s):  
S Mahaboob Fayaz
Keyword(s):  
Vitamin B12 ◽  
Case Control Study ◽  
Serum Vitamin ◽  
Case Control ◽  
Metformin Therapy ◽  
Type 2 Diabetics ◽  
One Year ◽  
Control Study

INTRODUCTION: Metformin is considered as the main drug of choice for the patients of type 2 diabetes mellitus. GI intolerance is a most common side effect seen in patients with long-term metformin therapy. Vitamin B12 deciency can be a consequence of metformin therapy due to malabsorption. In this study we sought to estimate vitamin B12 levels in patients who were on metformin therapy. MATERIALAND METHODS: The study is a case control study. 30 patients were on Metformin for more than one year (CASES) and the other 30 were on other anti-diabetic drugs and/or insulin for more than one year (CONTROLS). Serum vitamin B12 levels were measured by radioimmunoassay method. RESULT:In regard to vitamin B12 levels, this study clearly shows a decrease associated with Metformin therapy. CONCLUSION: Type 2 diabetics on long term Metformin therapy were found to have signicantly low levels of Vitamin B12 when compared to type 2 diabetics on other anti-diabetic drugs. Hence Vitamin B12 supplementation should be considered in patients with long term metformin therapy.

scholarly journals Evaluation of Vitamin B12 status in type 2 Diabetes Mellitus Patients on Metformin therapy

2018 ◽  
Vol 9 (2) ◽  
pp. 9-12
Author(s):  
Ananda Vayaravel Cassinadane ◽  
Ramesh Ramaswamy ◽  
Shaik Anwar Hussain ◽  
Radhika Govindarajan ◽  
Abu Raghavan Srinivasan
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Vitamin B12 ◽  
Tertiary Care ◽  
Care Hospital ◽  
C Peptide ◽  
Metformin Therapy ◽  
The Status

Background: B12 deficiency is a silent epidemic with serious consequences. Long term use of metformin has been associated with malabsorption of vitamin B12 leading to its deficiency along with increased homocysteine levels. With this background we designed this study to assess the status of vitamin B12 and its markers in type 2 diabetes mellitus patients on metformin therapy who are attending tertiary care hospital in the peripheral area of Pondicherry.Aims and Objective: The current study aims to study the relationship if any, between the glycemic status and the status of Vitamin B12 among T2DM patients on metformin therapy.Materials and Methods: A case control study was done with a sample size of 100 (50 case and 50 control). The patients were selected according to the inclusion criteria and their blood sample were analyzed for the various parameters. The markers of vitamin B12 status are studied among both the control and the patients with T2DM on metformin therapy and compared with their glycaemic status.Results: There is a significant increase in the levels of FBS, HbA1c, insulin and C-peptide in the study group. It was observed that the mean levels of homocysteine and Methylmalonic acid were significantly higher with lower levels of vitamin B12 in patients who were on metformin therapy.Conclusion: There is moderate correlation between the markers of B12 status and levels of fasting blood sugar as well as HbA1C. There is a significant correlation between insulin and C-peptide with the markers of vitamin B12 status.Asian Journal of Medical Sciences Vol.9(2) 2018 9-12

scholarly journals The prevalence and treatment of metformin associated Vitamin B12 deficiency in patients with type 2 Diabetes Mellitus in New Zealand

2021 ◽  
Author(s):  
◽  
Sylvan Haeusler
Keyword(s):  
Type 2 Diabetes ◽  
New Zealand ◽  
Vitamin B12 ◽  
Treatment Options ◽  
Serum Vitamin ◽  
Vitamin B12 Deficiency ◽  
Zealand Population ◽  
B12 Deficiency

<p>With an ever increasing incidence of type 2 diabetes in the New Zealand population, continual assessment must be made to ensure the ongoing evaluation of treatment options to ensure patient care is not compromised. Previous research has shown higher prevalence of Vitamin B12 deficiency in patients with type 2 Diabetes Mellitus who have had long term metformin treatment. An investigation into patients attending secondary care clinics at the Diabetes Clinic at Wellington Regional Hospital as well as primary health care patients has explored the prevalence of this interaction in the New Zealand population as well as assessed the factors that may contributed to such an effect. It was found that there is a high prevalence of decreased serum Vitamin B12 level in patients with type 2 Diabetes exposed to metformin treatment. Factors such as age and ethnicity were seen to be key predictors of this interaction and have shown a unique view of how the population of New Zealand may be affected. Treatment of decreased serum Vitamin B12 levels was seen to be effective through both sublingual and intramuscular methods with variations in both short and long term effects. The use of sublingual treatment administration of Vitamin B12 supplementation is unique in the scope of metformin induced Vitamin B12 deficiency and has shown potential to be a therapeutic route for patients affected by such an interactions. Current views on the interaction between metformin and serum Vitamin B12 levels are currently under debate in regards to physiological relevance and clinical outcomes. This paper provides a first look at the effect of this interaction in a New Zealand population and evaluates treatment options for such. Furthermore a proposal is made for an alternate mechanism of metformin action on Vitamin B12 levels which may aid understanding of observations made in both in this paper and previous studies.</p>

scholarly journals Increasing Vitamin B12 Screening Among Patients With Type 2 Diabetes on Long-Term Metformin Therapy

2021 ◽  
Author(s):  
Elijah P. Mays, Jr.
Keyword(s):  
United States ◽  
Type 2 Diabetes ◽  
Nurse Practitioners ◽  
Nurse Practitioner ◽  
Southeastern United States ◽  
Food Bank ◽  
Family Nurse Practitioners ◽  
Vitamin B12 Screening

The setting for this project was a free clinic that serves an underserved and underprivileged community in the southeastern United States. The patient population is 80% Hispanic and 20% African American and Caucasian. The clinic also serves the community by doubling as a food bank and clothing center. Clinician staffing at the clinic included three physicians, two family nurse practitioners (FNPs), one physician assistant (PA), and a mixture of nurse practitioner (NP) and PA students. The students rotated through the clinic for one semester or multiple semesters as they progressed through their graduate program’s plan of study.

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