Deficiency of Vitamin B12 in Type 2 Diabetic Patients Receiving Metformin Therapy at HMC Hospital Peshawar (original) (raw)
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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...
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.
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...
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...
2020
Objective: To compare the association of vitamin B12 deficiency and metformin use in patients presenting with type II diabetes mellitus. Study Design: Case control study. Place and Duration of Study: Department of Medicine, Military Hospital Rawalpindi from Apr 2017 to Sep 2017. Methodology: All patients who fulfilled the inclusion criteria and visited OPD of department of Medicine Military Hospital Rawalpindi, were included in the study. After approval from the ethical review committee, informed written consent was taken from patients. The patients were divided into two groups group A (metformin use) & B (without metformin use). Outcome was checked by comparing both the groups for vitamin B12 deficiency. Results: Two hundred and eighty patients with diabetes mellitus were included. One hundred and seventy one (61.07%) were males and 109 (38.93%) were females, with the mean age of 59.52 ± 12.441. Vitamin B12 deficiency in group I was seen in 30 (10.71%) and in 9 patients (3.21%) in ...
Asian Journal of Pharmaceutical and Clinical Research
Objectives: This study focused on the prevalence of Vitamin B12 deficiency in UAE patients with type 2 diabetes mellitus (T2DM) who were treated with or without metformin.Methods: A cross-sectional study was conducted on 213 patients having diabetes type II were randomly selected to be part of the study in Northern Regions of the UAE, from June 2014 to February 2015. The patients aged >45 years and who had taken metformin for at least 3 months were recruited with regular follow-up at the outpatient clinic. The patients were included in a survey after which they had their serum B12 levels measured. Serum B12 levels <150 pg/ml are defined as the B12 deficiency.Results: About 48% of diabetic patients had confirmed the B12 insufficiency through laboratory tests. The patients on metformin had statistically lower values of B12 (p=0.002). The majority of participants n (%) took metformin had neuropathy, hypertension, dyslipidemia, numbness or paresthesia, and depression, or mood chan...
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...
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...
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).
Asian Journal of Medical Research, 2019
Background: Diabetes is fast gaining the status of a potential epidemic in India, with more than 62 million diabetic individuals currently diagnosed with the disease. Subjects and Methods: 50, Type-2 diabetic patients on metformin therapy, with age ranging from 30 to 65 years and 50 healthy controls, were recruited from the General Medicine Department of Nimra Institute of Medical Sciences, according to inclusion and exclusion criteria. Results: In this study, the level of FBS, HbA1c, Fasting insulin, Homocysteine, C peptide, and Methyl Malonic acid were significantly increased (p <0.01), while Vitamin B12 levels were significantly decreased (p<0.01) in the study group, as compared to controls. It was observed that the mean level of vitamin B12 markers, homocysteine and methylmalonic acid were significantly higher and low level of vitamin B12 was found in patients who were on metformin therapy. Reports have shown that metformin use has a significant impact on the concentration of vitamin B12 in patients with T2DM.Conclusion: Metformin, which is the first line oral hypoglycemic agent as recommended by ADA, is significantly associated with decrease in vitamin B12 levels. 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.