There were only 16 patients (4.4%) who had available serum vitamin B12 levels. The data collection was done in the clinic using a data extraction form. 2017;354:16571, 19. Also, add a good amount of green leafy vegetables to your diet. There were 210 patients (57.9%) who were on vitamin B12 supplementation, of which 111 (30.6%) had a daily dose of 200 mcg. If you face a serious problem maintaining glucose, taking a vitamin B12 injection for almost 3 months will help you bring things in balance. This site needs JavaScript to work properly. Albai O, Timar B, Paun DL, Sima A, Roman D, Timar R. Diabetes Metab Syndr Obes. Recommendations for Practical Use of Metformin, a Central Pharmacological Therapy in Type 2 Diabetes. When taken at appropriate doses, vitamin B-12 supplements are generally considered safe. People who take metformin for type 2 diabetes have lower levels of vitamin B12. Mayo Clinic does not endorse any of the third party products and services advertised. 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. 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). 2008;89:693S6S, 29. Almost all such people who dont eat meat and dairy products are deficient in vitamin B12. Biochemical B 12 deficiency was defined as serum B 12 concentrations 148 pmol/L and borderline deficiency was defined as >148 to 221 pmol/L. Taylor & Francis does not sell reprints or permissions for this article. These symptoms are pain and numbness in the arms, legs, hands, and feet. Vitamin B12 deficiency symptoms Symptoms due to anaemia These are caused by the The cumulative dose of metformin during the study period is not an accurate reflection of the dose taken/compliance as a pill count (counting returned tablets) or prescription filling was not correlated, and hence the resultsshowing no significant difference between the sufficient and deficient B12 groupsshould be interpreted with caution. This vitamin is needed to make red blood cells, which carry oxygen to all parts of your body. Leung S, Mattman A, Snyder F, Kassam R, Meneilly G, Nexo E. Metformin induces reductions in plasma cobalamin and haptocorrin bound cobalamin levels in elderly diabetic patients Clin Biochem. Avoid drinking goat milk because its low in folate and vitamin B12. Two common types of GERD medicines have been associated with B-12 deficiency to varying degrees: H-2-receptor blockers. One standard first-line treatment for diabetes is metformin, which was reported to increase the risk for vitamin B12 deficiency. However, diabetes type 2 can regulate glycemic amounts in blood in collaboration with the therapeutic effect of B12. Unauthorized use of these marks is strictly prohibited. The first possible treatment option is to look at your diet. ated type 2 diabetes mellitus patients. Besides this, diabetic neuropathy will also affect the gastrointestinal tract of your body. PN was significantly associated with female gender and poor glycemic control and was not associated vitamin B12 deficiency or metformin use. In addition, female patients had higher levels of vitamin B12 compared to men (coefficient: 49.1; CI 95%: 2.3-95). In this study an inverse correlation was found between diabetic neuropathy and the plasma level of vitamin B12. Categorical variables appear as counts and percentages. Vitamin B12 deficiency is very serious because it leads to certain complications, including diabetes and anemia. This can happen if you don't eat 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. Before You'll soon start receiving the latest Mayo Clinic health information you requested in your inbox. Severe deficiency (e.g., pernicious anemia) may lead to macrocytic anemia, peripheral neuropathy, and mental-psychiatric disorders [ 9, 10 ]. 2016 Mar;39(3):305-14. doi: 10.1007/s40618-015-0365-9. [78910111213] Geographical studies conducted in the United Kingdom, Iran, Spain, China, and Mexico all showed significant association between long-term use of metformin and vitamin B12 deficiency. The site is secure. Association of vitamin B12 deficiency and metformin use in patients with type 2 diabetes J Korean Med Sci. Authors: News Author: Laurie Barclay, MD CME Author: Hien T. Nghiem, MD Log In to Start Journal of Family Medicine and Primary Care8(7):2306-2311, July 2019. 965972. Epub 2016 Apr 26. Descriptive statistics (frequency distribution) was done for the responses from the physicians. Please enable it to take advantage of the complete set of features! There was no difference in the prevalence of peripheral neuropathy in those with normal vitamin B12 levels and those with vitamin B12 deficiency. No potential conflict of interest was reported by the author(s). Type 2 Diabetes patients are often exposed to metformin, as it is an oral medication for hyperglycemia. Treatment Of B12 Deficiency In Diabetes Patients. 2014;29:1394400, 17. Type 2 diabetes mellitus patients who were on metformin for at least 1 year were included in the study. However, you can prevent the B-12 deficiency by taking a proper diet and supplements. [56] Reports have shown that vitamin B12 deficiency occurs in 5.830% of diabetic patients on long-term treatment with metformin. 2017;65:10616, 20. Vitamin B12 is an essential vitamin, and deficiency generally occurs with inadequate absorption or lack of dietary intake. You can control blood glucose level in your body by increasing intake of vitamin B12. You can obtain it through meat, poultry, fish, and dairy products. 2009;22:52834, 8. 2012;35:e84. The collected data was entered and analyzed by using Statistical Package for Social Sciences (SPSS) version 23.0 (SPSS Inc., IBM, Armonk, New York, USA). Vitamin B-12 deficiency is not common in the U.S. Table 1: Baseline characteristics of patients with diabetes at Princess Marina hospital diabetes clinic, between July 2017 and October 2017 (n=351). Russo GT, Giandalia A, Romeo EL, Scarcella C, Gambadoro N, Zingale R, Forte F, Perdichizzi G, Alibrandi A, Cucinotta D. J Endocrinol Invest. WebVitamin B 12 deficiency, (IR) and those without. 2021 Nov 26;9(33):10198-10207. doi: 10.12998/wjcc.v9.i33.10198. However, people who follow a vegetarian or vegan diet might be prone to deficiency because plant foods don't contain vitamin B-12. There were 107 patients (29.5%) who were on PPIs. Vitamin B12 deficiency was found in 96 (49.1%) of the patients. Epub 2021 Nov 24. Depression. Vitamin B12 deficiency is very serious because it leads to certain complications, including diabetes and anemia. An estimated sample size of 354 patients was calculated. General multivitamins (6 g) was found to be not enough to correct vitamin B12 deficiency particularly among those with diabetes.[8]. Several studies have unequivocally demonstrated that vitamin B12 deficiency is highly prevalent in adult diabetic patients [24]. Standards of medical care in diabetes Diabetes Care. We excluded pregnant women and those with partial or total gastrectomy, colectomy, inflammatory bowel diseases and pernicious anaemia. Among patients with type 2 diabetes (T2D), vitamin B 12 deficiency is common owing to medication interactions (eg, metformin) or malnutrition. SAGE Open Med. The most notable risk factor associated with vitamin B12 deficiency in adult individuals with diabetes in clinical practice is long term and high dose metformin therapy [46]. 2021 Jul 15;12(7):916-931. doi: 10.4239/wjd.v12.i7.916. WHO Media Centre. Also, a single-centre nature of the study limits the generalisation of the study findings. The clinic has been operational since 2011 as a referral centre for health facilities in Gaborone and nearby towns. There was no vitamin B12 deficiency in 53 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. E-mail: [emailprotected]. Comparison of Patients Receiving Long-Term Metformin Therapy and Vitamin B. 5 Howick Place | London | SW1P 1WG. 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. Bookshelf Foods fortified with vitamin B12, such as breakfast cereals, bread, tofu, and nutritional yeast, are fortified. Causes and pathophysiology of vitamin B12 and folate deficiencies. Left untreated, a vitamin B-12 deficiency can lead to anemia, fatigue, muscle weakness, intestinal problems, nerve damage and mood disturbances. This cross-sectional study was conducted at the diabetic clinics at four selected MoH hospitals in Riyadh, Saudi Arabia (King Salman Hospital, King Saud Medical City, Imam Abdulrahman Alfaisal Hospital and Prince Mohammad bin Abdulaziz Hospital) between August and November 2018. The majority were females (67.2%) and those with type 2 diabetes (92.9%). Vitamin B12 deficiency was defined by levels < 150pmol/l. Pflipsen M, Oh R, Saguil A, Seehusen D, Seaquist D, Topolski R. The prevalence of vitamin B12 deficiency in patients with type 2 diabetes: A cross-sectional study J Am Board Fam Med. Vitamin B-12 deficiency has potentially serious and sometimes irreversible complications if undiagnosed and untreated. Additional data, including demographic characteristics were collected. Viollet B, Guigas B, Garcia N, Leclerc J, Foretz M, Andreelli F. 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