An Investigation on Vitamin B12 Serum Levels among Type 2 Diabetic Patients Treated with Metformin Compared to Normal Levels (original) (raw)

Abstract

Background: Given the increasing prevalence of type 2 diabetes in the community and the use of metformin as one of its most common therapies as well as presence of some evidences on a link between the use of this medicine and vitamin B12 levels, we decided to measure and compare serum level of vitamin B12 among the diabetic patients under treatment by metformin and compare with its natural content. Decreased Vitamin B12 levels leads to some clinical problems including anemia, gastrointestinal disorders (diarrhea, constipation, decreased appetite, etc.,), neurological disorders (tingle, numbness, muscle weakness, etc.,) and mental disorders (memory impairment, depression, behavioral problems, etc.,). Therefore, we would determine if the duration of metformin use and dosage may be effective on serum levels of vitamin B12 among metformin-treated diabetic patients. Methods: Serum vitamin B12 level in metformin-treated type 2 diabetic patients referred to Rasoul-e-Akram Hospital and Spec...

Loading...

Loading Preview

Sorry, preview is currently unavailable. You can download the paper by clicking the button above.

References (21)

  1. Australian family physician. 2003;32(5): 383-4.
  2. Ting RZ, Szeto CC, Chan MH, Ma KK, Chow KM. Risk factors of vitamin B(12) deficiency in patients receiving metformin .Archives of internal medicine. 2006;166(18):1975-9.
  3. Wile DJ, Toth C. Association of metformin, elevated homocysteine, and methylmalonic acid levels and clinically worsened diabetic peripheral neuropathy. Diabetes care. 2010;33(1):156-61.
  4. Liu Q, Li S, Quan H, Li J. Vitamin B1 2 status in metformin treated patients: Systematic review. PloS One. 2014;9(6): e100379.
  5. Stabler SP. Clinical practice. Vitamin B12 deficiency. The New England Journal of Medicine. 2013;368(2):149-60.
  6. Pawlak R. Is vitamin B12 deficiency a risk factor for cardiovascular disease in vegetarians? American Journal of Preventive Medicine. 2015;48(6):e11-26.
  7. de Jager J, Kooy A, Lehert P, Wulffele MG, 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. 2010;340:c2181.
  8. Greibe E, Miller JW, Foutouhi SH, Green R, Nexo E. Metformin increases liver accumulation of vitamin B12 -An experimental study in rats. Biochimie. 2013;95(5):1062-5.
  9. Pierce SA, Chung AH, Black KK. Evaluation of vitamin B12 monitoring in a veteran population on long-term, high-dose metformin therapy. The Annals of Pharmacotherapy. 2012;46(11): 1470-6.
  10. Owhin SO, Adaja TM, Fasipe OJ, Akhideno PE, Kalejaiye OO, Kehinde MO. Prevalence of vitamin B12 deficiency among metformin-treated type 2 diabetic patients in a tertiary institution, South- South Nigeria. SAGE Open Med. 2019;7:2050312119853433.
  11. Shams M, Homayouni K, Omrani GR. Serum folate and vitamin B12 status in healthy Iranian adults. orientale = al- Majallah al-sihhiyah li-sharq al-mutawassit. 2009;15(5):1285-92.
  12. Khodabandehloo N, Vakili M, Hashemian Z, Zare Zardini H. Determining functional vitamin B12 deficiency in the elderly. Iran Red Crescent Med J. 2015;17(8):e13138.
  13. Fakhrzadeh H, Ghotbi S, Pourebrahim R, Nouri M, Heshmat R, Bandarian F, et al. Total plasma homocysteine, folate, and vitamin B12 status in healthy Iranian adults :the Tehran homocysteine survey (2003- 2004)/a cross-sectional population based study. BMC Public Health. 2006;6:29.
  14. Reinstatler L, Qi YP, Williamson RS, Garn JV, Oakley GP, Jr. Association of biochemical B(1)(2) deficiency with metformin therapy and vitamin B(1)(2) supplements: the National Health and Nutrition Examination Survey, 1999-2006. Diabetes care. 2012;35(2):327-33.
  15. Braza M HJ, Bhatla A, Martinez M. Prevalence of vitamin B12 deficiency in Hispanic; 2014.
  16. Metaxas C, Zurwerra C, Rudofsky G, Hersberger KE, Walter PN. Impact of type 2 Diabetes and Metformin use on Vitamin B12 Associated Biomarkers -an Observational Study. Experimental and clinical endocrinology & diabetes: Official Journal, German Society of Endocrinology [and] German Diabetes Association; 2018.
  17. Rodriguez-Gutierrez R, Montes-Villarreal J, Rodriguez-Velver KV, Gonzalez-Velazquez C, Salcido-Montenegro A, Elizondo-Plazas A, et al. Metformin use and vitamin B12 deficiency: Untangling the association. The American Journal of the Medical Sciences. 2017;35.71,-165:(2)4
  18. Gupta K, Jain A, Rohatgi A. An observational study of vitamin b12 levels and peripheral neuropathy profile in patients of diabetes mellitus on metformin therapy. Diabetes & Metabolic Syndrome. 2018;12(1):51-8.
  19. Lohmann AE, Liebman MF, Brien W, Parulekar WR, Gelmon KA, Shepherd LE, et al. Effects of metformin versus placebo on vitamin B12 metabolism in non-diabetic breast cancer patients in CCTG MA.32. Breast Cancer Research and Treatment. 2017;164(2):371-8.
  20. Sato Y, Ouchi K, Funase Y, Yamauchi K, Aizawa T. Relationship between metformin use, vitamin B12 deficiency, hyperhomocysteinemia and vascular complications in patients with type 2 diabetes. Endocrine Journal. 2013;60(12):1275-80.
  21. Kancherla V, Elliott JL, Jr., Patel BB, Holland NW, Johnson TM, 2nd, Khakharia A, et al. Long-term metformin therapy and monitoring for vitamin B12 deficiency among older veterans. Journal of the