Association of Vitamin B12 Deficiency and Metformin Use in Patients Presenting with Type II Diabetes Mellitus (original) (raw)
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Prevalence of vitamin B12 deficiency in Indian type 2 diabetes subjects on metformin therapy
International Journal of Medical Research and Review, 2017
Background: To find out the prevalence of vitamin B12 deficiency in Indian type 2 diabetes subjects on metformin therapy.Material & Methods: 161 type 2 diabetes subjects were studied over a period of 6 months at Karnataka institute ofendocrinology Bangalore. All subjects gave written informed consent. BMI, Waist circumference, FPG, PPPG and HBA1c were estimated. Vitamin B12 levels were estimated by electrochemiluiminescence. We have excluded patients taking alcohol, vitamin B12 supplements, pregnant woman, and type 1 diabetics. Subjects whose vitamin B12 less than 200 picogram/ml were considered to be deficient in vitamin B12. Subjects who were on metformin treatment for more than 6 months were included in the study.Results:118 diabetes subjects were males. They were in the age group of 30 to 80 years. Duration of diabetes was 1 to <5 years in 20.5%, 5 to <10 years in 28.5% and 10 years and morein 51% of diabetes subjects studied respectively. 55.9% of subjects had positive family history of type 2 diabetes. 112 subjects were on 1000 mg metformin for one year or more and 49 were on 2000 mg metformin for one year or more. Prevalence of vitamin B12 deficiency was 27.33%.Conclusions: The prevalence of vitamin B12 deficiency is 27.33% in type 2 diabetes subjects on metformin therapy. The percentage of deficiency increased with increase in dosage of metformin but there was no correlation to duration of metformin therapy.
American Journal of Health, Medicine and Nursing Practice
Background: Diabetes mellitus is on the rise at an alarming rate, and it has now become a global issue. Type 2 Diabetic Mellitus is a disease characterized by disturbances in glucose, protein, and fat metabolism. Diabetes has been increasingly common in recent decades, causing significant socioeconomic burden, particularly in poorer countries. Objective: To investigate the prevalence of vitamin B12 deficiency in Type 2 diabetes patients taking metformin. Methodology: This study was conducted on T2 diabetic patients in the Diabetic Department of Diabetes and Endocrinology HMC Hospital, Peshawar, for a year (10 February 2019 to 12 March 2020). The demographic data of the recruited patients was obtained after they gave their informed written consent. Patients inquired about their metformin use history, dosage, and duration of type 2 diabetes mellitus. A 5cc venous blood sample was taken from the arm and kept at 4 degrees Celsius. Vitamin B12 levels were measured using enzyme-linked imm...
Association Of Vitamin B12 Deficiency With Intake Of Oral Metformin In Diabetic Patients
Journal of Ayub Medical College, Abbottabad : JAMC, 2019
BACKGROUND It is estimated that 450 million people worldwide have diabetes mellitus Objective of the study was to determine effect of Metformin on vitamin B12 level among patients with type 2 diabetes mellitus. It is a cross sectional study conducted at Medicine department, Shalamar Hospital Lahore. METHODS Seventy-two patients of diabetes mellitus were included in the study. All patients who could have any other disease process that can lead to Vitamin B12 deficiency were excluded from the study. They were segregated into two groups, first one was getting metformin for the last 2 years and the second group was not taking metformin. Vitamin B12 levels were checked in all the patients and value of 150 pmol/L was taken as normal. RESULTS Out of 72 patients who participated in our study, 40 patients (55.5%) were taking metformin for more than two years while 32 patients (44.5%) were not taking metformin for the last two years. Mean age of patients taking metformin and not taking metfor...
National Journal of Medical Research, 2020
Introduction: Diabetes is non-communicable disease prevalent all over the world. Metformin is most commonly prescribed and first line anti-hyperglycaemic medication of type 2 diabetes mellitus patients. Vitamin B12- Intrinsic factor complex uptake by ileal cell surface receptors is a known to be a process dependent on calcium availability. Metformin affects calcium dependant membrane action. Hence intestinal absorption of Vitamin B12 is often decreased during chronic metformin therapy. Aims & Objectives: This study is done to assess the prevalence, severity and clinical implication of vitamin B12 deficiency in type 2 diabetes mellitus patients taking chronic metformin therapy. Methods: The study included total 50 type 2 diabetes patients as per inclusion and exclusion criteria. Detailed history, physical examination and laboratory evaluation CBC, peripheral blood smear, renal function test, FBS,PPBS, HbA1c, serum vitamin B12 assay, urine routine & microscopy of all 50 patients. Analysis was done with help of SPSS software and using Microsoft Excel 2012. Results: In our study, dosage of the metformin was highest among deficient group followed by borderline and normal. The mean duration of therapy with metformin is high in the deficient group. Hence the duration of therapy with metformin and the dose determines the development of vitamin deficiency. With duration of metformin and duration of diabetes showed non-significant P value which may be due to the small sample size. As it is a cross sectional study, the population is very low and it is difficult to study the P value in this population. But the mean value shows good correlation with duration and dosage of metformin therapy and duration of diabetes with B12 deficiency. Conclusion: Chronic metformin therapy is associated with B12 deficiency by causing asymptomatic vitamin B12 deficiency. Vitamin B12 level in the patients who were on chronic metformin therapy is useful to predict B12 deficiency as they are prone for B12 deficiency. The duration and dose of metformin therapy has affected the vitamin B12 status of type 2 diabetes mellitus patients.
Status of Serum Vitamin B12 in Type 2 Diabetes Mellitus Patients under Metformin Therapy
Nepal Journal of Health Sciences
Introduction: Type 2 diabetes mellitus, a prevalent global health problem, is a major cause of morbidity and mortality. Metformin, the most widely used hypoglycemic agent can lead to a deficiency of vitamin B12. Very less information is available regarding the relationship between metformin therapy and vitamin B12 deficiency in the Nepalese population. Objectives: The study aims to evaluate the level of vitamin B12 in cases of diabetes mellitus under metformin therapy and to access the relationship of serum vitamin B12 level with the duration of metformin therapy. Methods: A hospital-based cross-sectional study with 300 diagnosed diabetes mellitus cases under metformin therapy were enrolled in the study after the consent was taken. The prior ethical clearance was taken and the duration of the study was from December 2021 to June 2022. Results: The study showed 78% (n=234) of the total diabetic cases under metformin therapy had lower vitamin B12. In 50-60 years, age group, 91% of the...
BMJ Open Diabetes Research & Care, 2020
ObjectiveTo assess the prevalence of vitamin B12 deficiency in people with type 2 diabetes mellitus (T2DM) on metformin and without metformin.MethodologyBetween May 2018 and January 2019, this prospective multicenter observational study recruited participants from seven centers in four provinces of Pakistan (Sindh, Punjab, Baluchistan and Khyber Pakhtunkhwa). Participants with T2DM treated with metformin for >2 years and those not on metformin underwent assessment of hemoglobin, vitamin B12, homocysteine and diabetic neuropathy (vibration perception threshold (VPT) >15V) and painful diabetic neuropathy (Douleur Neuropathique 4 (DN4) ≥4) and Diabetic Neuropathy Symptom (DNS) score ≥1.ResultsOf 932 subjects, 645 (69.2%) were treated with metformin, while 287 (30.8%) were not on metformin. Overall, B12 deficiency (<200 pg/mL) was significantly higher in metformin users of 25 (3.9%), compared with non-metformin users of 6 (2.1%), while B12 insufficiency (200–300 pg/mL) was sign...
2020
Aim: Vitamin B12 deficiency is one of the major and common problem in subject with type 2 diabetes and this situation might get worsened in subjects who are on metformin therapy. The main aim of this study was to evaluate the effect of different dosage of metformin on serum Vitamin B12 in Indian Type 2 Diabetes (T2DM) subjects. Methods: This observational study was carried out in a tertiary care clinic where 365 patients were treated with metformin ≤ 1000 mg for at least 3 years (5± 0.9) and 360 patients were on metformin ≥ 1500 mg at least 3 years (5± 0.8). Demographical data was recorded in a predesigned format and blood glucose level was performed in a NABL accelerated pathological laboratory. Serum vitamin B12 was measured by using an immunoassay method. Results: Mean serum vitamin B12 levels in subjects who received higher dose of metformin (≥1500 mg) (259.19 ± 123.02) were significantly lower than in subjects who received lower dose of metformin (≤ 1000 mg) (307.31 ± 107.9) (p...
International Journal of Advances in Medicine, 2016
Background: Type 2 diabetes mellitus is associated with vitamin B12 deficiency which is further increased in patients who are on metformin therapy. The objective of this study is to determine the frequency of vitamin B12 deficiency among Indian patients with type 2 diabetes mellitus on metformin therapy compared to those who are not on metformin. Methods: The study was a hospital based, case control type of analytical study conducted in SMS Medical College & Hospital, Jaipur during a period of 1 year. The study group has 50 patients with a diagnosis of T2DM and a prescription history of metformin for ≥18 months and control group has 50 patients with diagnosis of T2DM and no history of metformin use in the past five years. The following data was recorded for each patient: age, sex, weight, height, body mass index (BMI), years with diabetes, total daily dose of and years on metformin. Serum vitamin B12 was measured using an immunoassay method. Data were statistically analyzed. Results: Mean serum vitamin B12 levels in the study group was 431.84±265.76 and in control was 744.76±271.927 and the difference was statistically significant. Mean serum vitamin B12 levels in vegetarians (547.27±303.011) were significantly lower than in non-vegetarian (699.22±307.992) (p value 0.029). A significant negative correlation existed between the S. vitamin B12 and duration of diabetes (r=-0.445) by using Pearson's correlation coefficient in study group. Conclusions: Metformin is significantly associated with decrease in vitamin B12. So we recommend that vitamin B12 should be measured prior to initiation of metformin therapy and later annually in patients of type 2 diabetes mellitus who are on metformin therapy for long duration (≥3-4 years) or in higher doses (≥2gm/day).
Evaluation of Vitamin B12 status in type 2 Diabetes Mellitus Patients on Metformin therapy
Asian Journal of Medical Sciences
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 w...
Vitamin B12 Deficiency in Diabetic Patients on Metformin Therapy: A cross-sectional study from Oman
Sultan Qaboos University Medical Journal [SQUMJ]
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 pa...