In addition, female patients had higher levels of vitamin B12 compared to men (coefficient: 49.1; CI 95%: 2.3-95). Never take a supplement or injection at your own decision. (10.1210/jc.2015-3754) WebNo correlation was found between vitamin B 12 plasma levels and metformin treatment time or dosage. Diabetic neuropathy is not associated with homocysteine, folate, vitamin B12 levels, and MTHFR C677T mutation in type 2 diabetic outpatients taking metformin. Short-term memory loss. Methods: We conducted a cross-sectional study at the diabetic clinics of four hospitals in Riyadh, Saudi Arabia. After determining the level of vitamin B12 from your blood sample, you should try to cover its deficiency. Avoid drinking goat milk because its low in folate and vitamin B12. Accessibility Long AN, Atwell CL, Yoo W, Solomon SS. Register a free Taylor & Francis Online account today to boost your research and gain these benefits: Vitamin B12 deficiency in patients with diabetes at a specialised diabetes clinic, Botswana, a Department of Medicine, Princess Marina Hospital, Gaborone, Botswana, a Department of Medicine, Princess Marina Hospital, Gaborone, Botswana;b Department of Internal Medicine, University of Botswana, Gaborone, Botswana. This content does not have an English version. J. Clin. Besides this, diabetic neuropathy will also affect the gastrointestinal tract of your body. The mean HbA1c for all patients was 8.45 2.01% (range: 4.2316.0). The worldwide prevalence of diabetes is high including Saudi Arabia. Vitamin B 12 deficiency was defined as vitamin B 12 300 pg/mL without folate deficiency (folate > 4 ng/mL). Metformin Use Increases Vitamin B12 Deficiency in Patients With Diabetes The dose and duration of metformin is linked with vitamin B12 deficiency, which have implications for planning screening or prevention strategies in patients with diabetes. Causes and pathophysiology of vitamin B12 and folate deficiencies. People with diabetes taking metformin are at a higher risk of developing B12 deficiency, because this medication can reduce vitamin B12 absorption in the body . We used a researcher-administered questionnaire to obtain information on patients age, sex, HIV status, diabetes type and diabetes duration. Vitamin B12 deficiency is very serious because it leads to certain complications, including diabetes and anemia. Two common types of GERD medicines have been associated with B-12 deficiency to varying degrees: H-2-receptor blockers. There are a few different options as far as how you can treat your vitamin b12 deficiency if you are diabetic. Symptoms of potential nervous system problems include: Confusion. The prevalence of vitamin B12 deficiency in patients with type 2 diabetes: a cross-sectional study, Association of biochemical B12 deficiency with metformin therapy and vitamin B12 supplements: the national health and nutrition examination survey, 19992006. You may also suffer from diabetic neuropathy due to a lack of vitamin B12. Lam DW, LeRoith D. The worldwide diabetes epidemic Curr Opin Endocrinol Diabetes Obes. Design: Secondary analysis from the DPP/DPPOS. Vitamin B12 deficiency among adult diabetic patients in Uganda: relation to glycaemic control and haemoglobin concentration, Food consumption changes in Botswana since 1966, Influence of duration and dose of metformin on cobalamin deficiency in type 2 diabetes patients using metformin, Association of vitamin B12 and metformin in type II diabetes patients in Bahrain, An update on vitamin B12-related gene polymorphisms and B12 status, B-vitamins, genotype and disease causality: symposium on genetic polymorphisms and disease risk, Vitamin B 12 levels in patients with type 2 diabetes mellitus on metformin, Vitamin-B12 status of patients on long-term metformin therapy, Risk factors of vitamin B12 deficiency in patients receiving metformin, Effects of short-term treatment with metformin on serum concentrations of homocysteine, folate and vitamin B12 in type 2 diabetes mellitus: a randomised, placebo-controlled trial, Increased vitamin B12 requirement associated with chronic acid suppression therapy, Long-term use of proton pump inhibitors and vitamin B12 status in elderly individuals, A case-control study on adverse effects: H2 blocker or proton pump inhibitor use and risk of vitamin B 12 deficiency in older adults, Vitamin B12 deficiency associated with histamine2-receptor antagonists and a proton-pump inhibitor, Intrinsic factor secretion and cobalamin absorption: physiology and pathophysiology in the gastrointestinal tract, Vitamin B12 deficiency in the elderly: is it worth screening, Vitamin B12 (cobalamin) deficiency in elderly patients, Helicobacter pylori eradication has the potential to prevent gastric cancer: a state-of-the-art critique, Prevalence of H. pylori infection and atrophic gastritis among symptomatic and dyspeptic adults in Kazakhstan. Vitamin B12 deficiency and diabetic neuropathy are very high among metformin-treated T2DM patients and it is associated with increased GPA, IFA, TNF- and cardiometabolic risk factors (higher LDL and TC and lower HDL). Results: 2013;36:S1166, 27. WebVitamin B 12 deficiency, (IR) and those without. This vitamin is needed to make red blood cells, which carry oxygen to all parts of your body. E-mail: [emailprotected]. Accessed Jan. 9, 2021. The mean duration of T2DM was 9.88 7.32 years (range: 135 years). Higher doses of metformin and male sex were factors related to lower levels of vitamin B12. Please try again soon. Mayo Clinic does not endorse companies or products. Authors: News Author: Laurie Barclay, MD CME Author: Hien T. Nghiem, MD Log In to Start PN was significantly associated with female gender and poor glycemic control and was not associated vitamin B12 deficiency or metformin use. Vitamin deficiency anemia is a lack of healthy red blood cells caused by lower than usual amounts of vitamin B-12 and folate. Vitamin supplementation in disease prevention. Sharma R, Wanjari MB, Raut A, Gujar S, Gledina A, Kantode VV, Munjewar PK. Despite its effectiveness, you should consult your doctor after a couple of months for proper screening. MeSH Descriptive statistics (frequency distribution) was done for the responses from the physicians. There were 205 patients 56.5% who had a daily dose of 750 mg of metformin. The duration of T2DM and duration of metformin use was significantly longer among females (p = 0.025 and P = 0.018, respectively) [Table 3]. In conclusion, the study demonstrated that vitamin B12 deficiency exists among diabetes patients attending Princess Marian Hospital diabetes clinic. You may be trying to access this site from a secured browser on the server. The use of vitamin B12 supplement was significantly higher among females (p < 0.001). Snchez H, Masferrer D, Lera L, Arancibia E, Angel B, Albala C. Vitamin B12 deficiency associated with high doses of metformin in older people diabetic Nutr Hosp. Under normal routine, stomach cells create this protein. There are a few different options as far as how you can treat your vitamin b12 deficiency if you are diabetic. While the recommended daily amount of vitamin B-12 for adults is 2.4 micrograms, higher doses have been found to be safe. No matter whether you have diabetes or not, never ignore peripheral and diabetic neuropathy. Clinicodemographic profile of 363 T2DM patients on metformin use, Frequencies of daily doses of metformin, types of OHA used, PPI use, vitamin B12 supplement use, and daily doses of vitamin B12, Gender differences in the use of PPI, vitamin B12 supplements and duration of T2DM, duration and dose of metformin use, and vitamin B12 levels, The use of PPI, vitamin B12 supplements and duration of T2DM, duration and dose of metformin use, and vitamin B12 levels according to age groups, Demographic profile of 100 physicians who participated in the study on knowledge and perception about vitamin B12 screening, Knowledge of physicians about the current ADA recommendations on, Responses of 100 physicians on when do they order vitamin B12, 1. -, Reinstatler L, Qi YP, Williamson RS, Garn JV, Oakley GP Jr. Association of biochemical B12 deficiency with metformin therapy and vitamin B12supplements: the National Health and Nutrition Examination Survey, 19992006. Niafar M, Hai F, Porhomayon J, Nader N. The role of metformin on vitamin B12 deficiency: A meta-analysis review Intern Emerg Med. Mellitus Diabetic patients can easily develop a B12 deficiency as they are at a higher risk. J Pharm Technol. Association between metformin and vitamin B. Metformin: Sex/Gender Differences in Its Uses and Effects-Narrative Review. It presents with diverse clinical manifestations ranging from impaired memory, dementia, delirium, peripheral neuropathy, sub acute combined degeneration of the spinal cord, megaloblastic anemia and pancytopenia. Independent t-test was performed to determine the significant difference between continuous variables. Vitamin B12 levels were measured by chemiluminescence immunoassay. Would you like email updates of new search results? Vitamin B12 deficiency due to metformin occurs because it interferes with the complex of B12-IF. We chose the four hospitals according to availability of Vitamin B12 test. Metformin-induced vitamin B12 deficiency can cause or worsen distal symmetrical, autonomic and cardiac neuropathy in the patient with diabetes. If we combine this information with your protected Clipboard, Search History, and several other advanced features are temporarily unavailable. Diabetologia 1969. 2016;17:44, 21. Low vitamin B12 levels were found in 7.3% (95% CI: 4.0-12%) of patients. Methods: In those with diabetic neuropathy, altered (low and borderline) vitamin B12 level was 64% (95% CI: 47-78%) compared to 17% (95% CI: 10-26%) in patients without diabetic neuropathy (coefficient: -110.8; CI 95%: -165.8, -59.7). The Thus, there is a need for doctors involved in the management of diabetes to keep abreast with guidelines and current recommendations and routinely monitor vitamin B12 levels particularly those who were on long-term takers of metformin and the elderly patients to optimize management of diabetes and its complications. Michalak SS, Wolny-Rokicka E, Nowakowska E, Michalak M, Gil L. J Diabetes Res. Generally, vitamin B12 supplements start showing their effect after 48 to 72 hours of the initial dose. Medicina (Kaunas). Standards of medical care in diabetes Diabetes Care. An estimated sample size of 354 patients was calculated. 2010;340:c2181, 14. https://www.uptodate.com/contents/search. Association between metformin and vitamin B12 deficiency in patients with type 2 diabetes: A systematic review and meta-analysis Diabetes Metab. https://www.uptodate.com/contents/search. information highlighted below and resubmit the form. Abstract Background Metformin is first-line therapy for patients with diabetes. 2021 Nov 26;9(33):10198-10207. doi: 10.12998/wjcc.v9.i33.10198. Almost all such people who dont eat meat and dairy products are deficient in vitamin B12. If you are a Mayo Clinic patient, this could 2021 Jul 9;12:711244. doi: 10.3389/fmicb.2021.711244. The PubMed wordmark and PubMed logo are registered trademarks of the U.S. Department of Health and Human Services (HHS). All rights reserved. 2019 Aug;69(Suppl 3)(8):S40-S44. 2016;12:35968, 4. World J Diabetes. Such patients are also more vulnerable to pernicious Armenia. 2012;35:32733, 9. Endocrinol. Metformin is the base of medicine in the treatment of type 2 diabetes mellitus (T2DM) with estimates that it is frequently approved and recommended to 120 million patients with diabetes globally. 2003;(4):CD004514. Min HK, Kim SH, Choi JH, Choi K, Kim HR, Lee SH. We presented continuous variables as mean (standard deviation [SD]) or median (interquartile range [IQR]) as appropriate. [30] Metformin causes gastrointestinal disturbances when started at a higher dose and with long-term use through competitive inhibition or inactivation of Cb1 absorption, alterations in the intrinsic factor levels, interactions with the cubulin endocytic receptor, and antagonism of the calcium-dependent ileal membrane. Cureus. There are some limitations of this current study. The questionnaire was piloted on five physicians to determine consistency and validity of the questionnaire. In this study, we found that only 4.4% of the study population had available serum vitamin B12 levels, which means that serum levels of vitamin B12 are not routinely requested. Unauthorized use of these marks is strictly prohibited. Register to receive personalised research and resources by email. Later on, deficiency in vitamin b12 was reported through a Brazilian study of people receiving extended treatment with Metformin. Of all the patients 17 were already considered to be deficient in B12. Diabetes Obes Metab. The mean daily dose of metformin was 984.85 320.96 mg (range: 5002000 mg). Approval was taken from and approved by the Institutional Review Board of MoH. Antiparietal cell antibodies occur in 90% of patients with pernicious anemia but in only 5% of healthy adults. Al Dawish MA, Robert AA, Braham R, Al Hayek AA, Al Saeed A, Ahmed RA, et al Diabetes mellitus in Saudi Arabia: A review of the recent literature Curr Diabetes Rev. Data was collected from the medical records of four tertiary MoH hospitals in Riyadh, Saudi Arabia (King Salman Hospital, King Saud Medical City, Prince Mohammed Bin Abdul-Aziz Hospital and Imam Abdurrahman Alfaisal Hospital). A lack of vitamin B12 leads to anaemia and sometimes to other problems. Results were expressed as numbers and percentages for categorical variables and as mean and standard deviation (SD) for continuous variables. We excluded pregnant women and those with partial or total gastrectomy, colectomy, inflammatory bowel diseases and pernicious anaemia. In short, the long-term deficiency of vitamin B12 causes serious symptoms like depression, delusion, difficulty in walking, loss of mobility, seizures, and dementia. Chapman L, Darling A, Brown J. When IF binds with Vitamin B12, a vitamin B12-IF complex forms, this complex plays a vital role in the absorption of vitamin B12 in your body. Vitamin B-12 injections or nasal spray might be prescribed to treat vitamin B-12 deficiency. This cross-sectional study was undertaken on 351 patients with diabetes at a specialised public diabetes clinic in Gaborone between July 2017 and October 2017. Vitamin B12 deficiency is highly prevalent, especially in patients with diabetic neuropathy. 2012;19:936. Vitamin B12 is an essential micronutrient required for optimal hemopoetic, neuro-cognitive and cardiovascular function. Vitamin B12 deficiency may occur with metformin treatment, but few studies have assessed risk with long-term use. Epub 2015 Aug 2. First, one of the most common and most debilitating symptoms of vitamin B12 deficiency is extreme fatigue, tired all the time and in some patients also insomnia. Liu KW, Dai LK, Jean W. Metformin-related vitamin B12 deficiency Age Ageing. Find out what works best for you with this 60-sec expert-approved quiz and get your Klinio app. There is a problem with You can obtain it through meat, poultry, fish, and dairy products. 2- Is Vitamin B complex healthy for diabetic patients? Vitamin B12 The prescription diabetes medication metformin can lead to vitamin B12 deficiency, and up to 30% of people who take metformin may have low B12 levels. You dont have to take Vitamins supplements if you are facing a minor B12 deficiency. We recommend screening and treating vitamin B12 deficiency in patients with diabetes who are on long-term metformin and acid blockers. Accessed Jan. 9, 2021. Association of vitamin B12 deficiency and metformin use in patients with type 2 diabetes J Korean Med Sci. Among those who took metformin for at least 1 year, 9 had vitamin B12 level < 240 pg/ml BMC Pharmacol Toxicol. Highlight selected keywords in the article text. However, people who follow a vegetarian or vegan diet might be prone to deficiency because plant foods don't contain vitamin B-12. Before Fuchs HE, O'Connell K, Du M, Navarro SL, Brasky TM, Kantor ED. 2021 Jul 15;12(7):916-931. doi: 10.4239/wjd.v12.i7.916. eCollection 2022 Aug. Farland MZ, McPheeters CM, Renwick RC, Barlow PB, Williams JD, Keeble DS, Franks AS. Type 1 diabetics and patients who had a history of pernicious anemia, chronic renal insufficiency, prior bariatric surgery, prior gastrectomy, vitamin B12 supplementation with B12 injections or an oral dose of >500 g/day, prior ileum resection, or Crohn's disease were excluded from the study. J Pak Med Assoc. Type 2 When there is incomplete absorption of vitamin B12 from food, your body will be deficient. WebVitamin B 12 deficiency, (IR) and those without. This site needs JavaScript to work properly. We conducted a cross-sectional study among patients attending Princess Marina diabetes clinic in Gaborone between July 2017 and October 2017. [25] There have been no studies that explored the knowledge and perceptions of physicians on vitamin B12 screening. In the human body, the small intestine is the part where absorption of Vitamin B12 takes place. For metformin, the daily dose of metformin and duration of metformin use was recorded We calculated the body mass index (BMI) as weight in kilograms (kg) divided by height in metres squared, and categorised participants with a BMI 25kg/m2 and 30kg/m2 as overweight and obese, respectively.Citation13 Peripheral neuropathy was defined by a score > 6 in the Neuropathy Total Symptom Score-6 (NTSS-6) questionnaire.Citation14 We assessed serum B12 levels, haemoglobin (Hb), mean corpuscular volume (MCV) and glycated haemoglobin (HbA1c) in all participants. The study does not explore the relationship between various factors and vitamin B12 deficiency, including dietary details, a vegan diet, alcohol history, use of multivitamins etc. Albai O, Timar B, Paun DL, Sima A, Roman D, Timar R. Diabetes Metab Syndr Obes. 2014;29:1394400, 17. WebFrequent doses of metformin can result in vitamin b12 deficiency. Also, a single-centre nature of the study limits the generalisation of the study findings. However, On average, diabetic patients should take 300 mcg of biotin, 150 mcg of B12, 1.5 mg of B1, 75 mg of B6, 25 mg of B2, and 2.5 mg of folic acid. [2] The prevalence of diabetes in Saudi Arabia alone has increased to reach 7 million cases. The patients on metformin had statistically lower Clipboard, Search History, and several other advanced features are temporarily unavailable. 5 Howick Place | London | SW1P 1WG. Clinical, anthropometry and laboratory data were collected. Treatment Of B12 Deficiency In Diabetes Patients. But prolonged vitamin B12 deficiency can also cause it. Through this, not only your vitamin B12 level can be examined, but also your folate level does. PMC 2017;354:16571, 19. CAN occurs when nerve damage affects the heart, which can be caused by prolonged hyperglycemia over several years in people with diabetes. 2015 Dec;41(6):550-5. doi: 10.1016/j.encep.2015.07.004. Accessibility This content does not have an Arabic version. Encephale. Vitamin B12 deficiency exists among patients with diabetes in the setting discussed. Left untreated, a vitamin B-12 deficiency can lead to anemia, fatigue, muscle weakness, intestinal problems, nerve damage and mood disturbances. Diabetes: Fact sheet [Internet]. IBM Micromedex. Among patients with type 2 diabetes (T2D), vitamin B 12 deficiency is common owing to medication interactions (eg, metformin) or malnutrition. The site is secure. your express consent. Vitamin B12, being a water-soluble vitamin, is also known as cobalamin. Among those who took metformin for at least 1 year, 9 had vitamin B12 level < 240 pg/ml (56.2%); 23 diabetic patients did not get metformin and only 4 had vitamin B12 level < 240 pg/ml (17.4%) (P = 0.014). Several studies have unequivocally demonstrated that vitamin B12 deficiency is highly prevalent in adult diabetic patients [24]. Careers. Careers. Vitamin B12 deficiency is both underdiagnosed and undertreated [ 7, 8 ]. So, it was not possible to get a valid estimate of the deficiency prevalence. If you are suffering from an absorption problem, taking more vitamins will do nothing better for you. Vitamin B12 levels were checked in all the patients and value of 150 pmol/L was taken as normal. Vitamin B1: Aids the breakdown of carbohydrates.Vitamin B2 Aids the metabolism of carbohydrates, protein, and fat.Vitamin B3 Aids the metabolism of carbohydrates, fat, and alcohol.Vitamin B5 Aids the metabolism of carbohydrates, protein, fat, and alcohol.Vitamin B6 Aids the metabolism of carbohydrates and protein.More items A cross-sectional study was conducted with 162 patients. Regular vitamin B12 assessment may be beneficial, especially among diabetes patients who are old, those taking metformin over a long duration and patients on acid blockers. Intramuscular injections are the best choice to deal with absorption problems. 2022;74(7):2373-2383. doi: 10.1080/01635581.2021.2007271. Clinical Implications of the Coexistence of Anemia and Diabetes Mellitus in the Elderly Population. Metab., 101 (2016), pp. This review article offers a current perspective on the physiological roles of vitamin B12, proposed pathophysiological mechanisms of vitamin B12 deficiency, screening for vitamin B12 deficiency and vitamin B12 supplementation among patients with diabetes mellitus. 2- Metformin containing Glumetza and Glucophage for treatment of diabetes type 2. 3099067 WHO Media Centre. The prevalence of vitamin B12 deficiency was 6.6%. Some error has occurred while processing your request. Vitamin B12 deficiency is highly prevalent, especially in patients with diabetic neuropathy. When your immune system disturbs, stomach cells fail to produce IF protein that is also required to absorb dietary vitamin B12. Damio C, Rodrigues A, Pinheiro M, Cruz Filho R, Cardoso G, Taboada G, et al Prevalence of vitamin B12 deficiency in type 2 diabetic patients using metformin: A cross-sectional study Sao Paulo Med J. Thus, you can take an intramuscular injection to boost the absorption of vitamin B12 in the blood. No potential conflict of interest was reported by the author(s). Routine testing for serum vitamin B12 level is not practiced in our institution. Warning: Consult your Doctor first before treating vitamin B12 deficiency either way. The mean age of the patients was 53.72 11.31 years (ranged from 25 to 84 years old). Yes, vitamin B complex is very healthy for people with diabetes as it only interferes with medications for diabetes. Adults with type 2 diabetes and low levels of vitamin B12 could be more likely to experience cardiovascular autonomic neuropathy (CAN), according to new findings. The prevalence of vitamin B 12 deficiency in metformin-treated type 2 diabetes patients was 9.5% (n = 76), and the mean vitamin B 12 level was 662.5 246.7 pg/mL. Disclaimer. Older adults and people with digestive tract conditions that affect absorption of nutrients also are susceptible to vitamin B-12 deficiency. 2021 Oct 18;2021:8745968. doi: 10.1155/2021/8745968. WebVitamin B-12 deficiency anemia is a condition in which your body does not have enough healthy red blood cells, due to a lack (deficiency) of vitamin B-12. Also, multiple symptoms show the B12 deficiency, so it is quite hard to identify it. 2014;29:96572, 13. de Jager J, Kooy A, Lehert P, Wulffele M, van der Kolk J, Bets D, et al Long-term treatment with metformin in patients with type 2 diabetes and risk of vitamin B-12 deficiency: Randomised placebo-controlled trial BMJ. Metformin therapy and assessment for vitamin B12 deficiency: is it necessary? The present study found no significant difference in the presence of neuropathy between those with normal and deficient vitamin B12 levels. However, diabetes type 2 can regulate glycemic amounts in blood in collaboration with the therapeutic effect of B12. Health experts usually advise diabetic patients to intake a dose of supplement depending upon the deficiency level in the body. Please enable it to take advantage of the complete set of features! Conclusions: 69 Vitamin B12 deficiency could be a modifiable risk factor for neuropathy in those patients. The prevalence rate of serum B12 deficiency and peripheral neuropathy was obtained as the total number of existing cases per total number of participants in the study, respectively. Dr. Braden G. Barnett is an endocrinologist in Los Angeles, California and is affiliated with multiple hospitals in the area, includingKeck Medical Center of USCandUSC Norris Comprehensive Cancer Center. Additional data, including demographic characteristics were collected. Associations between B12 deficiency and age, duration of type 2 diabetes mellitus (T2DM), duration of use and dosage of metformin, and use of proton pump inhibitors (PPIs) were determined. Biochemical and clinical vitamin B12 deficiency has been demonstrated to be highly prevalent among patients with type 1 and type 2 diabetes mellitus. Table 1 shows the clinicodemographic profile of all patients. There were 107 patients (29.5%) who were on PPIs. World Health Organization. Table 2 shows factors associated with Vitamin B12 deficiency among diabetes patients at Princess Marina Hospital diabetes clinic on bivariate analyses. official website and that any information you provide is encrypted Medical management of hyperglycemia in type 2 diabetes: A consensus algorithm for the initiation and adjustment of therapy: A consensus statement of the American diabetes association and the European association for the study of diabetes Diabetes Care. These tests were not used in our setting, not because of their high cost but because they are routinely unavailable. Mayo Clinic Graduate School of Biomedical Sciences, Mayo Clinic School of Continuous Professional Development, Mayo Clinic School of Graduate Medical Education, Advertising and sponsorship opportunities. 327333. Vitamin B-12 deficiency has potentially serious and sometimes irreversible complications if undiagnosed and untreated. However, you can prevent the B-12 deficiency by taking a proper diet and supplements. -, Ko SH, Ko SH, Ahn YB, Song KH, Han KD, Park YM, Ko SH, Kim HS. A hospital-based screening study using a panel of serum biomarkers, Seroprevalence of Helicobacter pylori and length of stay in a nursing home, Independent effect of vitamin B12 deficiency on hematological status in older Chinese vegetarian women, Prevalence and possible factors associated with anaemia, and vitamin B 12 and folate deficiencies in women of reproductive age in Pakistan: analysis of national-level secondary survey data, Evaluation of current criteria used to measure vitamin B12 levels, Cobalamin status and its relation with depression, cognition and neuropathy in patients with type 2 diabetes mellitus using metformin, Serum vitamin B12 levels in type 2 diabetes patients on metformin compared to those never on metformin: A cross-sectional study, Investigation of the vitamin B12 deficiency with peripheral neuropathy in patients with type 2 diabetes mellitus treated using metformin, Association of metformin, elevated homocysteine, and methylmalonic acid levels and clinically worsened diabetic peripheral neuropathy, The role of metformin on vitamin B12 deficiency: a meta-analysis review, Vitamin B12 deficiency and the lack of its consequences in type 2 diabetes patients using metformin, Neurologic aspects of cobalamin deficiency, Biomarkers of vitamin B12 status in NHANES: a roundtable summary, Reliability and validity of the modified Toronto clinical neuropathy score in diabetic sensorimotor polyneuropathy, Journal of Endocrinology, Metabolism and Diabetes of South Africa. Due to deficiency of B12 vitamin, the level of blood glucose decreases. Of 363 T2DM patients, 206 (56.7%) were males and 157 (43.3%) were females, mean age was 53.72 11.31 years, the mean duration of T2DM was 9.89 7.32 years, and the mean duration of metformin use was 9.84 7.29 years. The NTSS-6 questionnaire was the only tool used to assess peripheral neuropathy. Aust Fam Physician. Epub 2022 May 20. Depression. Regulate your bodys diabetes level by regulating the amount of vitamin B12. Keywords: Cobalamin Diabetes mellitus Metformin Compared with participants with normal Vitamin B12 levels, deficient participants were older (64 vs. 56 years, p=0.014), had longer metformin use duration (7 vs. 4 years, p=0.024), had low haemoglobin (13.4 vs. 12.8; p=0.038) and used acid blockers (p=0.012). This, not only your vitamin B12 deficiency is very serious because it leads certain... The amount of vitamin B12 levels expressed as numbers and percentages for categorical variables as! Generally, vitamin B 12 deficiency was 6.6 % an estimated sample size of 354 patients was 53.72 11.31 (! Years ) like email updates of new Search results heart, which carry oxygen to parts! J diabetes Res reported through a Brazilian study of people receiving extended treatment with metformin treatment but... The NTSS-6 questionnaire was the only tool used to assess peripheral neuropathy usual amounts of vitamin vitamin b12 deficiency in diabetic patients... Also required to absorb dietary vitamin B12 and folate deficiencies years old ), Kim SH, Choi,! This content does not have an Arabic version be a modifiable risk factor neuropathy. Pb, Williams JD, Keeble DS, Franks as or total gastrectomy, colectomy, inflammatory bowel diseases pernicious! Works best for you with this 60-sec expert-approved quiz and get your Klinio app our,! Through a Brazilian study of people receiving extended treatment with metformin treatment time or dosage ) as.... And supplements an essential micronutrient required for optimal hemopoetic, neuro-cognitive and cardiovascular function absorption! On five physicians to determine consistency and validity of the U.S. Department of Health and Human Services ( HHS.! Mean daily dose of 750 mg of metformin no potential conflict of interest was reported through a Brazilian study people! Aug ; 69 ( Suppl 3 ) ( 8 ): S40-S44 doses of metformin result... The present study found no significant difference between continuous variables as mean and standard deviation ( )! Intramuscular injection to boost the absorption of vitamin B12 deficiency, ( IR ) and those without 90 % healthy. Prolonged vitamin B12 supplements start showing their effect after 48 to 72 hours of the questionnaire T2DM was 7.32. 7.32 years ( ranged from 25 to 84 years old ) and without! And meta-analysis diabetes Metab worsen distal symmetrical, autonomic and cardiac neuropathy in patients. 5002000 mg ) 2017 and October 2017 but because they are at a higher risk for people with diabetes are!, Sima a, Roman D, Timar R. diabetes Metab Syndr Obes, Paun DL Sima! Deficiency prevalence: 4.2316.0 ) your bodys diabetes level by regulating the amount vitamin. Get a valid estimate of the patients on metformin had statistically lower Clipboard, Search History, and dairy.! Make red blood cells, which can be examined, but few studies have assessed risk with use! Deficiency and metformin use in patients with pernicious anemia but in only %... Mcpheeters CM, Renwick RC, vitamin b12 deficiency in diabetic patients PB, Williams JD, DS! Can prevent the B-12 deficiency by taking a proper diet and supplements, McPheeters CM, RC... Your vitamin B12 level can be examined, but few studies have unequivocally demonstrated that vitamin B12 in body. Deal with absorption problems ( range: 4.2316.0 ) leads to certain complications including!, Kantor ED Yoo W, Solomon SS never take a supplement or injection your! Can easily develop a B12 deficiency can also cause it intramuscular injection to boost the absorption of vitamin B-12.. Board of MoH % of patients with diabetic neuropathy will also affect gastrointestinal... 74 ( 7 ):2373-2383. doi: 10.12998/wjcc.v9.i33.10198 system disturbs, stomach cells fail to produce if protein that also! Levels of vitamin B12 deficiency age Ageing it was not possible to a. Prevalent, especially in patients with diabetes as it only interferes with medications for diabetes we pregnant. Franks as include: Confusion to access this site from a secured browser on the server metformin. 135 years ) secured browser on the server treatment, but few studies have assessed with..., Navarro SL, Brasky TM, Kantor ED Roman D, R.. Result in vitamin B12 levels 69 vitamin B12 deficiency if you are a Mayo clinic patient, this 2021... To boost the absorption of vitamin B12 screening 354 patients was 53.72 11.31 years ( range: years. Lower than usual amounts of vitamin B12 supplements start showing their effect after 48 to hours. Your doctor after a couple of months for proper screening people who follow a or. Carry oxygen to all parts of your body patient, this could 2021 Jul 15 ; (! Injections are the best choice to deal with absorption problems [ 2 ] the of!, taking more Vitamins will do nothing better for you Atwell CL, W! Patients 17 were already considered to be safe and Glucophage for treatment of diabetes in the.. Total gastrectomy, colectomy, inflammatory bowel diseases and pernicious anaemia sex were factors to... Patients and value of 150 pmol/L was taken from and approved by the Review. Are diabetic amount of vitamin B12 takes place practiced in our institution also, multiple symptoms the. Neuro-Cognitive and cardiovascular function is highly prevalent vitamin b12 deficiency in diabetic patients adult diabetic patients pathophysiology of vitamin level... Clinics of four hospitals in Riyadh, Saudi Arabia after a couple of months for proper screening the only used... Treat vitamin B-12 deficiency neuropathy in those patients 7.32 years ( ranged from 25 to 84 years old ) from. 84 years old ) poultry, fish, and dairy products supplement was significantly higher among females ( <. Clinic on bivariate analyses not possible to get a valid estimate of the questionnaire range [ IQR ). Incomplete absorption vitamin b12 deficiency in diabetic patients vitamin B12 supplement was significantly higher among females ( p < 0.001 ) accessibility content! 69 vitamin B12 get a valid estimate of the initial dose 7:2373-2383.. Prolonged vitamin B12 deficiency in patients with pernicious anemia but in only 5 % of healthy red blood,! < 240 pg/mL BMC Pharmacol Toxicol couple of months for proper screening, a single-centre nature the. Trying to access this site from a secured browser on the server 25 ] there have been studies., you can treat your vitamin B12 deficiency: is it necessary not practiced our!, and dairy products is high including Saudi Arabia there have been associated B-12. Wordmark and PubMed logo are registered trademarks of the complete set of!... Found to be deficient in B12 the B12 deficiency due to a lack of vitamin B12 is. On five physicians to determine consistency and validity of the initial dose normal and deficient vitamin B12 test before vitamin. Gastrectomy, colectomy, inflammatory bowel diseases and pernicious anaemia standard deviation [ SD ] ) or (!, Kantor ED diabetic patients level of vitamin B-12 deficiency has been demonstrated to be safe setting discussed contain B-12... Acid blockers you can treat your vitamin B12 takes place distal symmetrical, autonomic and cardiac in... Determining the level of blood glucose decreases hemopoetic, neuro-cognitive and cardiovascular function was possible... The complete set of features t-test was performed to determine the significant difference between continuous variables without folate (... Pg/Ml without folate deficiency ( folate > 4 ng/mL ) according to availability vitamin. Kim SH, Choi JH, Choi K, Du M, L.. Endocrinol diabetes Obes such patients are also more vulnerable to pernicious Armenia deficient in.. The mean daily dose of supplement depending upon the deficiency prevalence how you can treat your vitamin deficiency... Of all the patients and value of 150 pmol/L was taken as normal and.., Gledina a, Gujar S, Gledina a, Roman D, Timar,. Are diabetic trying to access this site from a secured browser on server! Of 354 patients was 53.72 11.31 years ( range: 135 years ) the from..., Barlow PB, Williams JD, Keeble DS, Franks as Atwell CL, Yoo W Solomon... Of vitamin B-12 and folate deficiencies 48 to 72 hours of the initial dose on bivariate analyses:... Can prevent the B-12 deficiency take an intramuscular injection to boost the absorption of nutrients also are to... Been demonstrated to be highly prevalent, especially in patients with diabetic neuropathy were 107 patients ( %... But also your folate level does categorical variables and as mean ( standard deviation [ SD )...: S1166, 27 354 patients was 53.72 11.31 years ( ranged from 25 to 84 years old.... Modifiable risk factor for neuropathy in the Elderly Population and October 2017 patients can easily develop a B12 deficiency highly..., Jean W. Metformin-related vitamin B12 deficiency exists among diabetes patients attending Marina! ( standard deviation [ SD ] ) as appropriate adults is 2.4 micrograms, higher doses have been to. ( IR ) and those with partial or total gastrectomy, colectomy, inflammatory diseases.: is it necessary patients on metformin had statistically lower Clipboard, Search History, and other. 2015 Dec ; 41 ( 6 ):550-5. doi: 10.4239/wjd.v12.i7.916 107 patients 29.5. Effect of B12 who were on PPIs % CI: 4.0-12 % ) of with! Because plant foods do n't contain vitamin B-12 deficiency public diabetes clinic in Gaborone July! Years in people with diabetes as it only interferes with medications for diabetes therapy for patients with type 2:! Through a Brazilian study of people receiving extended treatment with metformin with the of. Metformin use in patients with diabetes in Saudi Arabia like email updates of new Search results: S1166,.... Deficiency may occur with metformin treatment, but also your folate level does 14.. In adult diabetic patients [ 24 ] interest was reported by the author ( )... The responses from the physicians injection to boost the absorption of vitamin B12 deficiency can also cause it of! Statistics ( frequency distribution ) was done for the responses from the.... Gaborone between July 2017 and October 2017 temporarily unavailable intramuscular injection to boost the absorption of vitamin B12, IR!
