Filioussi K, Bonovas S, Katsaros T. Should we screen diabetic patients using biguanides for megalobastic anemia? The average B12 level in the blood was 223pg/ml. Taking omeprazole (Prilosec), lansoprazole (Prevacid) or Another serious thing that may happen to vitamin B12 deficient people is loss of smell and taste sensations. MeSH Check out these best-sellers and special offers on books and newsletters from Mayo Clinic Press. Viollet B, Guigas B, Garcia N, Leclerc J, Foretz M, Andreelli F. Cellular and molecular mechanisms of metformin: An overview Clin Sci. Among those who took metformin for at least 1 year, 9 had vitamin B12 level < 240 pg/ml 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. government site. Those taking a higher metformin dose had lower levels of vitamin B12 (coefficient: -0.061; CI 95%: -0.09, -0.024). 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. 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. Treatment Of B12 Deficiency In Diabetes Patients. Of all the patients 17 were already considered to be deficient in B12. Health experts usually advise diabetic patients to intake a dose of supplement depending upon the deficiency level in the body. 2019 Aug;69(Suppl 3)(8):S40-S44. Vitamin B12 deficiency due to metformin occurs because it interferes with the complex of B12-IF. One standard first-line treatment for diabetes is metformin, which was reported to increase the risk for vitamin B12 deficiency. The mean age of the patients was 53.72 11.31 years (ranged from 25 to 84 years old). A total of 363 T2DM patients who were on metformin were included in the study. There were 39 diabetic patients, 16 took metformin for at least 1 year. 2021 Oct 18;2021:8745968. doi: 10.1155/2021/8745968. Endocrinol. doi: 10.7759/cureus.28194. Vitamin B12 deficiency resulting from metformin use has been demonstrated in multiple studies. Well, vitamin B12 does not play a role in the management of blood glucose levels. Type 2 Diabetes Vitamin B12 Deficiency Hyperhomocysteinemia: Due to high cost for investigation serum homocysteine level was measured only in 6 patients and serum vitamin B12 level (cheaper test) was measured in 14 patients with prior permission from Ethics Committee. You can obtain it through meat, poultry, fish, and dairy products. [23], Vitamin B12 deficiency screening is recommended for diabetic patients on long-term treatment with biguanides including metformin. The use of vitamin B12 supplement was significantly higher among females (p < 0.001). Mayo Clinic is a nonprofit organization and proceeds from Web advertising help support our mission. BMJ 2010. c2181. Long-term metformin therapy and vitamin B12 deficiency: An association to bear in mind. We recommend screening and treating vitamin B12 deficiency in patients with diabetes who are on long-term metformin and acid blockers. Haeusler S, Parry-Strong A, Krebs JD. T2DM is a significant risk factor to the development of ischemic stroke. If a patients mood is low at the same time, this can easily be interpreted as depression. If youre 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. Using an assumed proportion of 9.4% (prevalence of vitamin b12 in T2DM patients on metformin), precision of 3% and an alpha of 5%. It said: A paired t-test showed that in group A [the group given B12], patients with vitamin B12 Association of vitamin B12 deficiency and metformin use in patients with type 2 diabetes. Lets discuss vitamin B12 deficiency, its reasons, and why its deficiency is serious for diabetes patients. 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. To make your body function smoothly, you should also take medications for the effective absorption of B12. Vitamin B12 levels were checked in all the patients and value of 150 pmol/L was taken as normal. 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. Using metformin therapy for a long time is a cost-effective and practical treatment of blood glucose level maintenance. The mean duration of metformin use was 9.84 7.29 years (range: 1.035 years). ated type 2 diabetes mellitus patients. Results About 29.66% of diabetic patients had confirmed the B12 insufficiency through laboratory tests. 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 . Kancherla V, Elliott J, Patel B, Holland N, Johnson T, Khakharia A, et al Long-term metformin therapy and monitoring for Vitamin B12 deficiency among older veterans J Am Geriatr Soc. All rights reserved. Vitamin B12 affects the dynamics of autonomic nervous system and its deficits has been linked to cardiovascular autonomic neuropathy therefore, vitamin B12 deficiency was The most commonly used oral hypoglycemic agent was gliclizide only in 138 (38.4%) of patients. Methods In this retrospective study, we recruited 412 Make sure to take a regular intake of this vitamin for diabetes and treatment of other diseases. Antiparietal cell antibodies occur in 90% of patients with pernicious anemia but in only 5% of healthy adults. Problems concentrating. This site needs JavaScript to work properly. Metab., 101 (2016), pp. Mayo Clinic does not endorse any of the third party products and services advertised. 2022 Jan;40(1):97-107. doi: 10.2337/cd21-0043. 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. J. Clin. Alshammari, Amal N.1,; Iqbal, Rafay1; Baksh, Iqra Peer2, 1Department of Family and Community Medicine, Joint Program, Riyadh, Saudi Arabia, 2Department of Dermatology, General Practitioner, Riyadh, Saudi Arabia, Address for correspondence: Dr. Amal N. Alshammari, Department of Family and Community Medicine, Joint Program, Resident R 3, Riyadh, Saudi Arabia. This outpatient cross-sectional study found 6.6% of patients with diabetes at Princess Marina Hospital diabetes clinic to be vitamin B12 deficient. It depicts that vitamin B12 absorption is a calcium-dependent process. We defined vitamin B12 deficiency as serum B12 levels < 150pmol/l.Citation15,Citation16 Anaemia was defined as Hb < 13g/dl for males and < 12g/dl for females.Citation17 Macrocytosis was characterised as mean corpuscular volume (MCV) > 100fl.19.Citation18. sharing sensitive information, make sure youre on a federal Top Warning Signs of B12 DeficiencyTiredness. If you often feel exhausted, regardless of how much sleep youve gotten or how much energy youve exerted, it could be a sign that your body is lacking Mood swings. Do you find yourself experiencing a variety of emotions throughout any given day? It may result in depression. Digestive issues. Inflammation of the mouth and tongue. Insomnia. More items There were 39 diabetic patients, 16 took metformin for at least 1 year. Approvals were taken from the directors of the four hospitals prior to data collection. Vitamin B12 levels were measured by chemiluminescence immunoassay. Vitamin B12 deficiency was found in 96 (49.1%) of the patients. 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. Short-term memory loss. Vitamin B12 deficiency was defined as serum levels less than 148 pmol/L or 200 pg/mL.[24]. WebConclusion: The prevalence of vitamin B12 deficiency is considerable among diabetic patients on metformin therapy. Routine vitamin B12 screening may prevent irreversible nerve damage in type-2 diabetes Patients with type-2 diabetes, taking metformin, should have their vitamin B12 levels assessed more regularly to avoid irreversible nerve damage, according to a new study presented at the Society for Endocrinology annual conference in Glasgow. [3], Metformin has been one of the most widely used antidiabetic agents taken orally. 2003;(4):CD004514. We used a researcher-administered questionnaire to obtain information on patients age, sex, HIV status, diabetes type and diabetes duration. Berchtold P, Bolli P, Arbenz U, Keiser G. Disturbance of intestinal absorption following metformin therapy (observations on the mode of action of biguanides) [in German]. Please refer to the 'Licensing' tab on the article menu bar for information on the reuse conditions associated with this license type. Curr Diab Rep. 2021 Aug 27;21(9):31. doi: 10.1007/s11892-021-01397-1. If you face a serious problem maintaining glucose, taking a vitamin B12 injection for almost 3 months will help you bring things in balance. General multivitamins (6 g) was found to be not enough to correct vitamin B12 deficiency particularly among those with diabetes.[8]. You may opt-out of email communications at any time by clicking on Take supplements of calcium regularly along with metformin to stimulate the absorption of vitamin B12. We used a researcher-administered questionnaire to obtain information on the article menu bar for information on the reuse associated... Mean duration of metformin use has been one of the third party and... Recommend screening and treating vitamin B12 deficiency resulting from metformin use has been demonstrated in multiple studies % ) the! 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