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.

scholarly journals Vitamin B12 Deficiency in Diabetic Patients on Metformin Therapy: A cross-sectional study from Oman

2020 ◽  
Vol 20 (1) ◽  
pp. 90
Author(s):  
Ahmed Al-Hamdi ◽  
Mohammed Al-Gahhafi ◽  
Shihab Al-Roshdi ◽  
Sanjay Jaju ◽  
Ali Al-Mamari ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Vitamin B12 ◽  
Vitamin B12 Deficiency ◽  
Cross Sectional Study ◽  
Diabetic Patients ◽  
Sectional Study ◽  
Cross Sectional ◽  
Metformin Therapy ◽  
B12 Deficiency

Objectives: This study aimed to determine the prevalence of vitamin B12 deficiency amongst diabetic patients on metformin therapy. Methods: This cross-sectional study was conducted at general clinics at the University Health Center and diabetes outpatient clinics at Sultan Qaboos University Hospital, Muscat, Oman, between January and December 2017. All Omani adults who were diagnosed with type 2 diabetes mellitus and took metformin were invited to participate in the study. The variables included in this study were age, gender, duration of diabetes, dose and duration of metformin therapy, haemoglobin and glycosylated haemoglobin level. Results: A total of 248 subjects were included (response rate = 95.4%) of which 26 (10.5%) were vitamin B12 deficient and 53 (21.4%) were borderline deficient. The mean daily dose of metformin was highest among vitamin B12 deficient group (1,981 ± 222 mg; P = 0.004). Conclusion: The prevalence of vitamin B12 deficiency is considerable among diabetic patients on metformin therapy. Further research is needed to confirm the need for routine screening and monitoring.Keywords: Type 2 Diabetes Mellitus; Prevalence; Metformin; Vitamin B12 Deficiency; Oman.

scholarly journals Correlation of vitamin B12 deficiency with metformin therapy in type 2 diabetes mellitus patients

2020 ◽  
Vol 7 (2) ◽  
pp. 200
Author(s):  
S. B. Nayyar ◽  
Manbir Kaur Dhillon ◽  
Sahiba Kukreja
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Vitamin B12 ◽  
Serum Vitamin ◽  
Vitamin B12 Deficiency ◽  
Metformin Therapy ◽  
B12 Deficiency ◽  
Group B

Background: Diabetes mellitus is an endocrine and metabolic disorder, characterized by hyperglycemia. Metformin is the first line pharmacotherapy recommended by ADA. It has been recognized that metformin use is associated with serum vitamin B12 deficiency. The objective of this study is to determine the prevalence of serum vitamin B12 deficiency among Indian patients with type 2 diabetes mellitus on metformin therapy compared to those who are not on metformin.Methods: Here, 90 patients of type 2 diabetes mellitus of both sexes were included in this cross-sectional study conducted from January 2018 to August 2019 in SGRDIMSR, Sri Amritsar. They were divided into two groups; Group A of 60 subjects of type 2 diabetes mellitus on metformin therapy >1 year and group B of 30 subjects of type 2 diabetes mellitus not on metformin or had stopped taking metformin 6 months back. Serum vitamin B12 levels were measured using a Chemiluminescence method.  Data was statistically analysed.Results: The serum vitamin B12 levels were 190.02±90.75 pmol/l in group A (metformin users) and 586.9±243.69 pmol/l in group B (not metformin users) (p value=0.002). A significant negative correlation existed between the serum vitamin B12 and duration and dose of metformin use (r꞊ -0.676) and (r -0.855) by using Pearson’s correlation coefficient in group A.Conclusions: Metformin is associated with decrease in serum vitamin B12 levels. Annual screening of serum vitamin B12 is recommended for patients of type 2 diabetes mellitus who are on metformin therapy for longer duration and /or in higher doses.

scholarly journals The vitamin B12 levels in type 2 diabetes mellitus patients on metformin and not on metformin

2021 ◽  
Vol 8 (2) ◽  
pp. 165
Author(s):  
Ramesh Dasarathan ◽  
Rajendran Velayudham ◽  
Haridoss Krishnan ◽  
Senthilkumar S.
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Vitamin B12 ◽  
Serum Vitamin ◽  
Vitamin B12 Deficiency ◽  
Metformin Therapy ◽  
Significant Difference ◽  
B12 Deficiency

Background: Type 2 diabetes mellitus (T2DM) is one of the major global public health concerns, metformin is one of the most widely used drugs and considered as first-line therapy for management of T2DM. Vitamin B12 malabsorption is observed in patients on metformin therapy leading to biochemical and clinical vitamin B12 deficiency. The aim of the current study was to assess the relationship between metformin therapy and development of vitamin B12 deficiency.Methods: Current observational cross sectional study was conducted at Madras medical college and Rajiv Gandhi Government general hospital. Serum vitamin B12 and other blood investigation parameters of T2DM patients, on metformin therapy for long duration (6 months or more than 2 years) were measured and correlated with vitamin B12 levels of T2DM patients not on metformin therapy. Patients were given appropriate treatment and were regularly followed up.Results: Results of the current study findings depicted that significant difference was observed in percent haemoglobin, total blood cells, platelet count, mean corpuscular volume (MCV) and albumin values of patients on metformin therapy when compared to patients who were not on metformin therapy. Study findings also revealed that substantial difference in vitamin B12 deficiency was observed in T2DM patients based on the duration of metformin therapy.Conclusions: Current study revealed that, metformin therapy for 2 years or more, can lead to significant vitamin B12 deficiency which is also associated with macrocytosis. It was concluded that longer the duration of metformin therapy, more significant would be vitamin B12 deficiency.

scholarly journals A cross sectional study to estimate the prevalence of vitamin B12 deficiency among type 2 diabetes cases on metformin therapy: a one year study

2021 ◽  
Vol 8 (5) ◽  
pp. 657
Author(s):  
Veeranarayana Gundu ◽  
Venkata Subrahmanyam Chintha
Keyword(s):  
Type 2 Diabetes ◽  
Vitamin B12 ◽  
Vitamin B12 Deficiency ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Cross Sectional ◽  
Metformin Therapy ◽  
B12 Deficiency ◽  
One Year

Background: Type 2 diabetes mellitus is associated with long term neurological complications. Metformin usage as first line drug for longer duration is associated with Vitamin B12 deficiency. Metformin on longer usage is associated with B12 deficiency in various studies and prevalence is variable. The study aims to estimate the prevalence of Vitamin B12 deficiency and its associated risk factors among T2DM on metformin therapy.Methods: A cross sectional study for one year was conducted at Narayana Medical college a tertiary care hospital. All T2DM cases attending the department and on Metformin usage were enrolled and data of age, sex, duration of T2DM, dosage of Metformin were noted as variables. Levels of Hb1Ac and complete blood picture were noted. Statistical analysis was conducted by Statistical package for social sciences (SPSS) version 21 v and p<0.05 was considered statistically significant.Results: A total of 258 participants were enrolled of which 68 (26.36%) were B12 deficient, 46 cases (17.83%) moderately deficient and 144 (55.81%) were normal. Prevalence of Vitamin B12 in the study was 26.36%. There was a statistically significant association between Vitamin B12 levels and daily dose of metformin usage. (p>0.005)Conclusions: Our study clearly highlighted the association of Vitamin B12 deficiency among T2DM on metformin therapy. Prevalence of Vitamin B12 deficiency among T2DM patients on metformin is quite considerable and cannot be neglected. Physicians prescribing the drug should plan inclusion Vitamin B12 supplementation as regular drug in T2DM cases.

scholarly journals A genetic perspective of Metformin induced Vitamin B12 deficiency in Type 2 Diabetes mellitus patients

2018 ◽  
Vol 9 (1) ◽  
pp. 11-14 ◽  
Author(s):  
Ananda Vayaravel Cassinadane ◽  
Ramesh Ramaswamy ◽  
Radhika Govindarajan ◽  
Abu Raghavan Srinivasan
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Vitamin B12 ◽  
Vitamin B12 Deficiency ◽  
Medical Sciences ◽  
Laboratory Reference ◽  
B12 Deficiency

Metformin, a commonly prescribed hypoglycemic agent is a first line medication for the management of Type 2 diabetes mellitus. Numerous studies have depicted that metformin therapy has been associated with vitamin B12 and folate deficiency. Vitamin B12 deficiency is frequently missed or misdiagnosed by the clinicians because it is not routinely tested by most of the physicians, further the low end of the laboratory reference range is too low and misinterpreted as diabetic peripheral neuropathy. Vitamin B12 deficiency is a silent epidemic with serious consequences. Long term use of metformin has been associated with increased homocysteine levels and malabsorption of vitamin B12 leading to its deficiency and  neurological manifestations. Polymorphisms of certain genes associated with the metabolism of vitamin B12 and folate might help in predicting the deficiency status of vitamin B12.Asian Journal of Medical Sciences Vol.9(1) 2018 11-14

576-P: Prevalence of Vitamin B12 Deficiency and Clinical Neuropathy with Metformin Use in Type 2 Diabetes Mellitus Patients

Diabetes ◽  
2019 ◽  
Vol 68 (Supplement 1) ◽  
pp. 576-P
Author(s):  
VEERAPPA KOTHIWALE ◽  
NAHUSH D. CHAFEKAR ◽  
PRAKASH BABALICHE ◽  
NIKHIL A. CHOUGULE
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Vitamin B12 ◽  
Vitamin B12 Deficiency ◽  
B12 Deficiency

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.

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