Vitamin B12 deficiency in patients with type 2 diabetes mellitus

Authors

  • Tarun Sekhri Director,Institute of Nuclear Medicine and Allied Sciences (INMAS), Timarpur, Delhi, India
  • Rashmi Aggarwal Department of Thyroid and Endocrine Research, Institute of Nuclear Medicine and Allied Sciences (INMAS), Timarpur, Delhi, India
  • Pradeep Chugh Department of Cardiology, Institute of Nuclear Medicine and Allied Sciences (INMAS), Timarpur, Delhi, India
  • Shreeshail Belagavi Department of Lab Medicine, Institute of Nuclear Medicine and Allied Sciences (INMAS), Timarpur, Delhi, India
  • Hemant Aggarwal Deputy Medical Superintendent, BK Hospital, Faridabad, Haryana, India

DOI:

https://doi.org/10.18203/2349-3933.ijam20192251

Keywords:

Metformin, Neuropathy, Type 2 diabetes, Vitamin B12

Abstract

Background: Vitamin B12 deficiency may occur consequent to long-term treatment with metformin but very few studies in India have assessed this risk. Metformin is considered the drug of first choice not only for the management of type 2 diabetes but also for prediabetes and polycystic ovary disease. The study was carried out to assess the serum levels of vitamin B12 in Indian patients with type 2 diabetes mellitus who were treated with metformin for a minimum duration of five years.

Methods: Serum vitamin B12 level was estimated in 39 patients with type 2 diabetes mellitus, who were on metformin for more than five years. vitamin B12 deficiency was defined as serum concentration less than 200 pg/dl. Apart from vitamin B12, fasting blood sugar, post prandial sugar and glycosylated hemoglobin were also estimated.

Results: 39 subjects in age group of 40-65 years, suffering from type 2 diabetes mellitus, for more than five years were recruited for the study. The mean serum level of vitamin B12 was 153.27±46.01. Vitamin B12 deficiency was found in 35.89% subjects.

Conclusions: Patients suffering from long standing type 2 diabetes mellitus and taking large doses of metformin should be screened for Vitamin B 12 deficiency.

References

Kirpichnikov D, Ncfarlane SI, Sowers JR. Metformin: an update. Am Intern Med. 2002;137:25-33.

Tomkin GH, Hadden DR, Weaver JA, Montgomery DA. Vitamin-B12 status of patients on long-term metformin therapy. Br Med J. 1971 Jun 19;2(5763):685-7.

Khanduri U, Shamma A, Joshi A. Occult cobalamine and folate deficiency in Indians. The National Med J India. 2005;18(4).

Yajnik CS, Deshpande SS, LubreeHG, Naik SS, Bhatt DS, Uradey BS, et al. Vitamin B12 deficiency and hyperhomocysteine in rural and urban population in India. Indians J Association Physicians India. 2006;54:775-82.

Singh AK, Kumar A, Karmarkar D, Jha RK. Association of vitamin B12 deficiency and clinical neuropathy with metformin use in type 2 diabetes patient. 2013;59(4):253-7.

Farvid MS, Homayouni F. Factors associated with vitamin B12, folate and homocysteine levels in persons with type 2 diabetes. Clin Chem Lab Med. 2012;50:A48.

Calvo RSM, Lozano RJN. Vitamin B12 in type 2 diabetic patients treated with metformin. Endocrine native. 2012;59(8):487-90.

Qureshi SA, Ainworth A, Winocour PH. Metformin therapy and assessment of for vitamin b12 deficiency. is it necessary. Practical Diabetes. 2011;28(7):302-4.

Bell DS. Metformin induced vitamin B12 deficiency presenting as a peripheral neuropathy. South Med J. 2010;103(3):265-7.

Greibe E, Miller JW, Fortoushi SH, Green R, Nexo E. Metformin increases liver accumulation of vitamin B12-an experimental study in rats. Biochem. 2013;95:1063-5.

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Published

2019-05-24

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Original Research Articles