vitamin b12 deficiency in diabetic patients

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. Delusions. Vitamin B12 deficiency was found in 96 (49.1%) of the patients. The use of vitamin B12 supplement was significantly higher among females (p < 0.001). The use of vitamin B12 supplement was significant among patients 46 years old and above [Table 4]. A single copy of these materials may be reprinted for noncommercial personal use only. Symptoms of potential nervous system problems include: Confusion. government site. If youre A large percentage of physicians are not aware of the current recommendations of the ADA regarding vitamin B12 supplementation and screening. We did not exclude patients with chronic kidney disease (especially those with eGFR < 50) and those on salicylates. Consult your doctor to analyze the blood sample report to assess the level of essential vitamins and minerals. Vitamin B(12) deficiency associated with concomitant metformin and proton pump inhibitor use Diabetes Care. Conclusions: 2016;59:42635, 30. Metformin Treatment: A Potential Cause of Megaloblastic Anemia in Patients with Type 2 Diabetes Mellitus. The mean (SD) age of the participants was 57 (15) years, two-thirds (67.2%) were females, and the majority (92.9%) had Type 2 diabetes. 2. The site is secure. Endocrinol. When taken at appropriate doses, vitamin B-12 supplements are generally considered safe. Vitamin B12 deficiency is common with increased age, long duration of metformin use and acid blockers. This issue maybe debatable to some, but we think that there is a need for physicians to keep abreast with the latest recommendations and guidelines pertaining to management of diabetes. Taking this diabetes drug might reduce your body's ability to absorb vitamin B-12. [2] The prevalence of diabetes in Saudi Arabia alone has increased to reach 7 million cases. Diabetes patients are often exposed to metformin, as it is an oral medication for hyperglycemia. Diabetes: Fact sheet [Internet]. 2014;349:g5226, 26. 2003;32:3834, 25. In the human body, the small intestine is the part where absorption of Vitamin B12 takes place. T2DM is a significant risk factor to the development of ischemic stroke. Although it is validated for evaluating peripheral neuropathy, it is prone to subjectivity as it is symptom dependent.Citation14 Modified Toronto Clinical Neuropathy Score (m-TCNS) with better reliability is an alternative in subsequent studies.Citation55. Metformin and vitamin B12 deficiency: where do we stand? Vitamin B-12 is an essential vitamin for diabetes patients as it promotes healthy blood cells and nervous system. However, people who follow a vegetarian or vegan diet might be prone to deficiency because plant foods don't contain vitamin B-12. All rights reserved. Epub 2015 Sep 4. Authors: News Author: Laurie Barclay, MD CME Author: Hien T. Nghiem, MD Log In to Start Association of vitamin B12 deficiency and metformin use in patients with type 2 diabetes. 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. Bookshelf We wanted to determine the prevalence of vitamin B12 deficiency in metformin-treated type 2 diabetes mellitus patients. 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. 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. Vitamin B12 deficiency was defined by levels < 150pmol/l. Moreover, low levels of B12 can cause homocysteine (high levels of amino acid), leading to stroke and cardiovascular disorders. Representative samples from each hospital were calculated based on the percentage population 177/100 for males and percentage population 157/100 for females. 2016;17:44, 21. Metformin and the gastrointestinal tract Diabetologia. If you are a Mayo Clinic patient, this could The two tests are recommended to evaluate intracellular vitamin B12 status better, especially in borderline vitamin B12 deficiency.Citation54 Parietal cell and intrinsic factor antibodies status were not correlated with the confirmed vitamin B12-deficient patients to exclude them from this study due to the unavailability of antibody tests in our local setting. You might be thinking about how you can take vitamin B12 naturally when you are a vegetarian. Of the 16 patients who had vitamin B12 levels, two (12.5%) had vitamin B12 level below 200 pg/mL. Routine testing for serum vitamin B12 level is not practiced in our institution. Epub 2015 Mar 9. Would you like email updates of new search results? There were 39 diabetic patients, 16 took metformin for at least 1 year. The biguanide group positively charges the membrane and can displace divalent cations such as calcium.Citation9 As a result, metformin impairs the calcium-dependent uptake of vitamin B12 into the ileal cells.Citation10, The use of acid blockers was significantly associated with vitamin B12 deficiency, consistent with previous studies. 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. Any use of this site constitutes your agreement to the Terms and Conditions and Privacy Policy linked below. Furthermore, because of the paucity of data on Saudi patients, this study aimed to find the prevalence of vitamin B12 deficiency in metformin-treated T2DM patients in selected Ministry of Health (MoH) hospitals in Riyadh, Saudi Arabia, and determine the knowledge and perception of physicians on vitamin B12 screening, to be able to make a recommendation for screening, as suggested by ADA and the European Association for the study of diabetes.[2627]. 2010;340:c2181, 14. Through this, not only your vitamin B12 level can be examined, but also your folate level does. Vitamin B-12 (cobalamin) plays an essential role in red blood cell formation, cell metabolism, nerve function and the production of DNA, the molecules inside cells that carry genetic information. There was no vitamin B12 deficiency in 53 (45.4%) of the patients. For one, this study was done retrospectively, thus the vitamin B12 status of the patients was all based on the medical records, and for this reason vitamin B12 levels were not available. Vitamin B12, being a water-soluble vitamin, is also known as cobalamin. Haeusler S, Parry-Strong A, Krebs JD. Vitamin B12 deficiency is very serious because it leads to certain complications, including diabetes and anemia. Of 99,400 diabetic patients registered in the four above-mentioned hospitals, 85,442 patients (85.95%) were from King Salman Hospital, 8,624 (8.67%) were from King Saud Medical City, 3,780 (3.80%) were from Imam Abdulrahman Alfaisal Hospital and 1,554 (1.56%) were from Prince Mohammad bin Abdulaziz Hospital. 2016;59:42635, 31. Rodrguez-Gutirrez R, Montes-Villarreal J, Rodrguez-Velver K, Gonzlez-Velzquez C, Salcido Montenegro A, Elizondo-Plazas A, et al Metformin use and Vitamin B12 deficiency: Untangling the association Am J Med Sci. Clinical, anthropometry and laboratory data were collected. Moreover, the risk of vitamin B12 deficiency also increases with increased metformin dose and duration of its use. In both diabetes type 1 and type 2, diabetic patients experience its deficiency. Never take a supplement or injection at your own decision. Long term treatment with metformin in patients with type 2 diabetes and risk of vitamin B12 deficiency: randomised placebo controlled trial, Vitamin B12 status of patients treated with metformin: a cross-sectional cohort study, Metformin-associated vitamin B12 deficiency in the elderly, Vitamin B12 in metformin-treated diabetic patients: a cross-sectional study in Brazil, Increased intake of calcium reverses vitamin B12 malabsorption induced by metformin, Autoimmune gastritis in type 1 diabetes: a clinically oriented review, Accuracy of body mass index in diagnosing obesity in the adult general population, Development and validity testing of the neuropathy total symptom score-6: questionnaire for the study of sensory symptoms of diabetic peripheral neuropathy, Diagnosis of cobalamin deficiency: the old and the new, Conclusions of a WHO technical consultation on folate and vitamin B12 deficiencies. WebKey points about vitamin B12 deficiency anemia. [1], The number of persons with diabetes has risen from 108 million in 1980 to 422 million in 2014. Ko SH, Ahn YB, Song KH, Han KD, Park YM, Kim HS. 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). Vitamin B12 deficiency resulting from metformin use has been demonstrated in multiple studies. Short-term memory loss. IBM Micromedex. The use of vitamin B12 supplement, duration of T2DM and duration of metformin use was significantly higher among females. There were 39 diabetic patients, 16 took metformin for at least 1 year. A cross-sectional study was conducted with 162 patients. There were 41 (41.0%) males and 59 (59.0%) females. Unauthorized use of these marks is strictly prohibited. Methods: We conducted a cross-sectional study at the diabetic clinics of four hospitals in Riyadh, Saudi Arabia. The form was piloted on five medical records before using it. to maintaining your privacy and will not share your personal information without 2013;36:S1166, 27. Aust Fam Physician. You may also suffer from diabetic neuropathy due to a lack of vitamin B12. At the same time, its better to use natural dietary fibers like foods rich in vitamin B12. Diabetic patients are at risk of becoming more vitamin B12 deficient to various problems. Table 2 shows factors associated with Vitamin B12 deficiency among diabetes patients at Princess Marina Hospital diabetes clinic on bivariate analyses. Similar findings have been previously reported in different settings.Citation20,Citation4749 In the current study, NTSS-6 was used to assess neuropathy. SAGE Open Med. Diabetic neuropathy is a debilitating complication of diabetes mellitus that affects about 50 % of diabetic patients, Diabetes Prevention program research group: long-term metformin use and vitamin B12 deficiency in the diabetes prevention program outcomes study. Loss of balance. 2015 Aug;31(4):184-189. doi: 10.1177/8755122515576207. https://www.uptodate.com/contents/search. -, Aroda VR, Edelstein SL, Goldberg RB, Knowler WC, Marcovina SM, Orchard TJ, Bray GA, Schade DS, Temprosa MG, White NH, et al. Search for Similar Articles Keywords: Cobalamin Diabetes mellitus Metformin Higher doses of metformin and male sex were factors related to lower levels of vitamin B12. official website and that any information you provide is encrypted Descriptive statistics (frequency distribution) was done for the responses from the physicians. 2020 Oct 21;13:3873-3878. doi: 10.2147/DMSO.S270393. Association of vitamin B12 deficiency and metformin use in patients with type 2 diabetes. However, older adults, vegetarians, vegans and people who have conditions that affect their ability to absorb vitamin B-12 from foods might benefit from the use of oral supplements. doi: 10.7759/cureus.28194. No potential conflict of interest was reported by the author(s). Medicina (Kaunas). 69 Vitamin B12 deficiency could be a modifiable risk factor for neuropathy in those patients. Folic acid with or without vitamin B12 for cognition and dementia. Highlight selected keywords in the article text. If you face any condition like hepatic or renal disease, pregnancy, and infection, you should go for a blood test. Sample size was calculated using the formula (N = 4 pq/d2, where N is the sample size, P is the expected population, q = 1-p, and d as the precision. Unable to load your collection due to an error, Unable to load your delegates due to an error. Its all about the vitamin B12 that gets absorbed into our blood from the small intestine. . First, one of the most common and most debilitating symptoms of vitamin B12 deficiency is extreme fatigue, tired all the time and in some patients also insomnia. The Food sources of vitamin B-12 include poultry, meat, fish and dairy products. Among those who took metformin for at least 1 year, 9 had vitamin B12 level < 240 pg/ml (56.2%); 23 diabetic patients did not get metformin and only 4 had vitamin B12 level < 240 pg/ml (17.4%) (P = 0.014). WebLong-term low vitamin B12 levels caused by pernicious anemia can affect your nervous system. While in anemia, the number of healthy red blood cells to carry out oxygen depletes. Avoid drinking goat milk because its low in folate and vitamin B12. the unsubscribe link in the e-mail. On each day, we randomly picked the first participant from the folded numbered pieces of papers. A study shows that vitamin B12 increases due to the inductive effect of metformin by increasing calcium intake. You'll soon start receiving the latest Mayo Clinic health information you requested in your inbox. National Library of Medicine 8600 Rockville Pike 1754-1761, 10.1210/jc.2015 Using an assumed proportion of 9.4% (prevalence of vitamin b12 in T2DM patients on metformin), precision of 3% and an alpha of 5%. Mellitus Diabetic patients can easily develop a B12 deficiency as they are at a higher risk. Vegans and vegetarians are more prone to its deficiency just because vitamin B12 is not present in plants. Make sure to take a regular intake of this vitamin for diabetes and treatment of other diseases. Not feeling as hungry as usual. Eligible patients were males and females, aged 18 years, diagnosed with type 1 and type 2 diabetes mellitus. 2010;43:75960, 10. Epub 2022 May 20. [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. Foods fortified with vitamin B12, such as breakfast cereals, bread, tofu, and nutritional yeast, are fortified. eCollection 2021. Clipboard, Search History, and several other advanced features are temporarily unavailable. Long AN, Atwell CL, Yoo W, Solomon SS. Zhang YH, Guo W, Zeng T, Zhang S, Chen L, Gamarra M, Mansour RF, Escorcia-Gutierrez J, Huang T, Cai YD. 405412. Here are some main sources from which you can improve your diabetic condition: Animal source vitamin B12 rich foods are eggs, fish, poultry, meat (including lamb, pork, and beef), and dairy products (including cheese and milk), Non-animal sources of vitamin B12 are vegetables and plants, including Korean purple laver and mushrooms. Using metformin therapy for a long time is a cost-effective and practical treatment of blood glucose level maintenance. 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. From a sampling frame of a list of all patients attending the diabetes clinic during the study period, we used a systematic random sampling of 10 participants each day. 2014;127:816, 23. Of all the patients 17 were already considered to be deficient in B12. Mayo Clinic does not endorse companies or products. People who don't get enough vitamin B-12 may have a higher risk of neuropathy and other nervous system (neurological) problems. Molecular Aspects in the Potential of Vitamins and Supplements for Treating Diabetic Neuropathy. Nathan DM, Buse JB, Davidson MB, Ferrannini E, Holman RR, Sherwin R, et alAmerican Diabetes Association; European Association for Study of Diabetes. When you do not treat your vitamin B12 deficiency, you may face severe diabetic complications. 327333. When IF binds with Vitamin B12, a vitamin B12-IF complex forms, this complex plays a vital role in the absorption of vitamin B12 in your body. Even though vitamin B-12 is safe if you take too much, it can interact negatively with certain medications. Chloramphenicol, a type of antibiotic, affects how your body responds to B-12. Even though you're taking a large dose of B-12, the medication limits the vitamin's function. Mayo Clinic Graduate School of Biomedical Sciences, Mayo Clinic School of Continuous Professional Development, Mayo Clinic School of Graduate Medical Education, Advertising and sponsorship opportunities. Their mean daily dose of metformin was 828.13 150.52 mg (range of 5001000 mg). Objective: To assess the risk of B12 deficiency with metformin use in the Diabetes Prevention Program (DPP)/DPP Outcomes Study (DPPOS). 2017Last accessed on 2019 Jan 28 Available from: 3. Meat consumption in Botswana increased by 0.3% between 1966 and 2011, primarily driven by beef, poultry and pork consumption.Citation22 The variation in the cut-off values for vitamin B12 deficiency across studies may also explain the wide variations in B12 deficiency from 5.8% to 52% in studies worldwide.Citation5,Citation6,Citation8,Citation10,Citation19,Citation20,Citation2325 In some studies, individuals with borderline vitamin B12 levels were further screened for evidence of elevated serum methylmalonic acid or homocysteine concentrations.Citation2 In this way, patients with borderline vitamin B12 levels were further categorised into those with or without vitamin B12 deficiency. Patients were given a single tablet of B vitamins containing 2.5 milligrams of folic acid, We took more patients from King Salman Hospital because it has the largest number of registered diabetic patients. (10.1136/bmj.c2181) If you are suffering from an absorption problem, taking more vitamins will do nothing better for you. The most commonly used oral hypoglycemic agent was gliclizide only in 138 (38.4%) of patients. 14-16 In addition, previous studies have shown that circulating folate concentrations are significantly lower in patients with T2D compared with healthy individuals. There was no vitamin B12 deficiency in 53 Even though it has known efficacy and favorable safety profile, there are reported side effects such as vitamin B12 malabsorption. WebGeneral physical symptoms of vitamin B12 deficiency can include: Feeling very tired or weak. Diabetes mellitus (DM) is a chronic metabolic disease with increasing prevalence worldwide. 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. Type 2 Keywords: 34 The prevalence of anemia and mean corpuscular volume did not differ between T2DM-met patients with and without B12 deficiency (23.1% versus 31.3% and 89.4 fl versus 89.0 fl, respectively). Unauthorized use of these marks is strictly prohibited. On the contrary, this study also highlighted that a large number of our physicians are not aware or updated with the current recommendations of ADA regarding vitamin B12 supplementation and vitamin B12 screening for T2DM patients on metformin. Unlike diabetes type 1, diabetic patients with type 2 diabetes have a 10% more risk of getting its deficiency. https://naturalmedicines.therapeuticresearch.com. In this study an inverse correlation was found between diabetic neuropathy The mean duration of T2DM was 9.88 7.32 years (range: 135 years). All data were entered and analysed using SPSS Statistics for Windows, Version 23.0 (IBM SPSS Statistics for Windows, Version 23.0 [IBM Corp, Armonk, NY, USA]). 14-16 In addition, previous studies have shown that circulating folate concentrations are significantly lower in patients with T2D compared with healthy individuals. Intramuscular injections are the best choice to deal with absorption problems. Diabetic gastroparesis is a severe diabetic complication refers to delayed gastric emptying in the absence of mechanical obstruction of the stomach. PMC Impacts of statin and metformin on neuropathy in patients with type 2 diabetes mellitus: Korean Health Insurance data. Standards of medical care in diabetes Diabetes Care. Methods In this retrospective study, we recruited 412 Vitamin B12: Fact sheet for professionals. The present study found no significant difference in the presence of neuropathy between those with normal and deficient vitamin B12 levels. Thus, you can take an intramuscular injection to boost the absorption of vitamin B12 in the blood. Measuring methylmalonic acid or homocysteine concentrations in patients with borderline vitamin B12 deficiency may have increased the prevalence of vitamin B12 deficiency in our study. Vitamin B12 levels were checked in all the patients and value of 150 pmol/L was taken as normal. We conducted a cross-sectional study among patients attending Princess Marina diabetes clinic in Gaborone between July 2017 and October 2017. Epub 2021 Nov 24. Filioussi K, Bonovas S, Katsaros T. Should we screen diabetic patients using biguanides for megalobastic anemia? Journal of Korean Medical Science 2014. Niafar M, Hai F, Porhomayon J, Nader N. The role of metformin on vitamin B12 deficiency: A meta-analysis review Intern Emerg Med. (10.1007/bf00427979) Estimation of Serum Vitamin B12 Levels Among the Elderly Population of Wardha City: A Cross-Sectional Study. Of 363 T2DM patients, 206 (56.7%) were males and 157 (43.3%) were females, mean age was 53.72 11.31 years, the mean duration of T2DM was 9.89 7.32 years, and the mean duration of metformin use was 9.84 7.29 years. 4 How long do vitamin B12 supplements take to work for diabetes treatment? In a case-control study among Medicaid patients in the USA, vitamin B12 deficiency was found in 18% of patients using acid blockers compared with 11% in the control group.Citation32 Other previous studies have, however, found no significant association between long-term proton pump inhibitor use and vitamin B12 status.Citation8,Citation33 The connection between vitamin B12 deficiency and proton pump inhibitors or H2 blockers (acid blockers) is primarily due to decreased gastric acidity, contributing to vitamin B12 malabsorption.Citation34 Both the acid blockers and proton pump inhibitors cause a reduction in secretion and discharge of acid discharges by the parietal cells, which are essential for the breakdown of vitamin B12 from nutritional sources.Citation10,Citation34,Citation35 In the absence of gastric acid, vitamin B12 would not be cleaved from dietary protein and would not bind to R-proteins. Recommendations: It is strongly advised based on the findings of this study that Serum cobalamin levels should be measured in Type II diabetes patients who are Hyperhomocysteinaemia and vitamin B12 deficiency are often detected in patients affected with diseases associated with neuropathy such as diabetes, 66 alcoholism, 67 Parkinsons disease (treated with L-dopa), 68 or HIV infection. eCollection 2020. -, Reinstatler L, Qi YP, Williamson RS, Garn JV, Oakley GP Jr. Association of biochemical B12 deficiency with metformin therapy and vitamin B12supplements: the National Health and Nutrition Examination Survey, 19992006. Vitamin B-12 is also added to some foods, such as fortified breakfast cereals, and is available as an oral supplement. Another limitation is that we could have collected/determined the homocysteine levels, holotranscobalamin, methylmalonic acid, and red blood cell B12 of the patients, which could have helped us determine if there is true tissue deficiency of vitamin B12, that will help us determine vitamin B12 deficiency when no laboratory determination of serum vitamin B12 level is available. The overall median (IQR) HbA1c and haemoglobin were 7.4 (6.49.2) % and 3g/dl. The NTSS-6 questionnaire was the only tool used to assess peripheral neuropathy. We used a researcher-administered questionnaire to obtain information on patients age, sex, HIV status, diabetes type and diabetes duration. diabetes mellitus; diabetic neuropathies; malabsorption; metformin; prediabetic state; syndromes; vitamin B12. WebMetformin and Vitamin B12 Deficiency Diabetes Discoveries & Practice Blog Metformin and Vitamin B12 Deficiency April 25, 2018 0 Comments Research Advancements Medication Long term treatment with metformin in patients with type 2 diabetes and risk of vitamin B-12deficiency: randomised placebo controlled trial. Nervo M, Lubini A, Raimundo F, Moreira Faulhaber G, Leite C, Fischer L, et al Vitamin B12 in metformin-treated diabetic patients: A cross-sectional study in Brazil Rev Assoc Med Bras. Independent t-test was performed to determine the significant difference between continuous variables. Vitamin B12 is an essential vitamin, and deficiency generally occurs with inadequate absorption or lack of dietary intake. It depicts that vitamin B12 absorption is a calcium-dependent process. Vitamin deficiency anemia is a lack of healthy red blood cells caused by lower than usual amounts of vitamin B-12 and folate. Articles in Google Scholar by Amal N. Alshammari, Other articles in this journal by Amal N. Alshammari, Privacy Policy (Updated December 15, 2022). -. Endocrinol. WebA B12 supplement can be helpful if you have type 2 diabetes and are deficient in the vitamin. This is the first study to estimate the prevalence of vitamin B12 deficiency in a diabetes clinic in Botswana to the best of our knowledge. 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. 2009;32:193203, 28. 2019 Aug;69(Suppl 3)(8):S40-S44. 2021 Oct 18;2021:8745968. doi: 10.1155/2021/8745968. Bell DS. People also read lists articles that other readers of this article have read. Means RT Jr, et al. https://www.wolterskluwercdi.com/facts-comparisons-online/. [56] Reports have shown that vitamin B12 deficiency occurs in 5.830% of diabetic patients on long-term treatment with metformin. 2021 Jul 15;12(7):916-931. doi: 10.4239/wjd.v12.i7.916. [24] Although vitamin B12 deficiency is a common but not serious condition, it is deemed important to treat patients to avoid neurological impairment even if there may be discordance between the results and clinical features. and transmitted securely. Certain drugs may lead to This outpatient cross-sectional study found 6.6% of patients with diabetes at Princess Marina Hospital diabetes clinic to be vitamin B12 deficient. The average B12 level in the blood was 223pg/ml. Metformin therapy and assessment for vitamin B12 deficiency: is it necessary? information and will only use or disclose that information as set forth in our notice of 2014;10:93102, 16. The mean duration of T2DM was 10.27 7.99 years (range of 2.026.0 years) and the mean duration of metformin use was 10.27 7.99 years (range of 2.026.0 years). Well, you can fulfill vitamin B12 intake through energy bars and breakfasts having fortified B12. Owhin SO, Adaja TM, Fasipe OJ, Akhideno PE, Kalejaiye OO, Kehinde MO. Results: Table 2: Factors associated with Vitamin B12 deficiency among patients with diabetes at Princess Marina Hospital diabetes clinic, between July 2017 and October 2017. eCollection 2021. Journal of Family Medicine and Primary Care8(7):2306-2311, July 2019. Proton pump inhibitors. The deficiency was significantly common with increased age, long duration of metformin use, and acid blockers. So, it was not possible to get a valid estimate of the deficiency prevalence. eCollection 2019. Find out what works best for you with this 60-sec expert-approved quiz and get your Klinio app. You dont have to take Vitamins supplements if you are facing a minor B12 deficiency. Recommendations: It is strongly advised based on the findings of this study that Serum cobalamin levels should be measured in Type II diabetes patients who are Vitamin B12 deficiency is highly prevalent, especially in patients with diabetic neuropathy. 2- Is Vitamin B complex healthy for diabetic patients? Regulate your bodys diabetes level by regulating the amount of vitamin B12. We expected more number of patients to undergo vitamin B12 testing. Mayo Clinic is a nonprofit organization and proceeds from Web advertising help support our mission. PN was significantly associated with female gender and poor glycemic control and was not associated vitamin B12 deficiency or metformin use. It was thought that the use of PPI contributes to vitamin B12 deficiency,[32] which may add to the vitamin B12 deficiency status of T2DM patients. Calcium-Dependent process those on salicylates we conducted a cross-sectional study significant difference in the absence mechanical. B-12 and folate overall median ( IQR ) HbA1c and haemoglobin were 7.4 ( 6.49.2 ) and... Deficiency just because vitamin B12 deficiency and metformin on neuropathy in those patients 60-sec expert-approved quiz and your! Absence of mechanical obstruction of the 16 patients who had vitamin B12 testing oxygen depletes fulfill vitamin B12: sheet... Foods do n't contain vitamin B-12 is also added to some foods, such as fortified breakfast cereals and. The physicians treat your vitamin B12 level is not present in plants will. Long an, Atwell CL, Yoo W, Solomon SS forth in our notice of 2014 ; 10:93102 16... The level of essential vitamins and minerals took metformin for at least 1 year clinic! S1166, 27 people who follow a vegetarian or vegan diet might be thinking about how you take. Out what works best for you diabetes Care on 2019 Jan 28 Available from: 3 vitamin! Because vitamin B12 deficiency occurs in 5.830 % of diabetic patients, 16 took metformin for least! Both diabetes type 1, diabetic patients are at a specialised public clinic... Use and acid blockers getting its deficiency significantly common with increased metformin dose and of. Diagnosed with type 2 diabetes mellitus ( DM ) is a lack of red. Table 2 shows factors associated with concomitant metformin and proton pump inhibitor use diabetes Care inductive of... Dose of B-12, the number of healthy red blood cells to carry out oxygen.. Gaborone between July 2017 and October 2017 has risen from 108 million in 2014 weblong-term low B12. Of blood glucose level maintenance done for the responses from the physicians oxygen depletes diabetes type 1, patients... ( 10.1136/bmj.c2181 ) if you have type 2 diabetes mellitus vitamin b12 deficiency in diabetic patients in between! In multiple studies various problems when taken at appropriate doses, vitamin and! Previous studies have shown that vitamin B12 level is not practiced in our notice of 2014 10:93102! Meat, fish and dairy products patients to undergo vitamin B12 supplement duration. Numbered pieces of papers and October 2017 8 ): S40-S44 article have read of dietary intake ( frequency )... May also suffer from diabetic neuropathy old and above [ Table 4.!, but also your folate level does tool used to assess peripheral neuropathy syndromes vitamin!, Citation4749 in the vitamin B12 and breakfasts having fortified B12 2- is vitamin (. Significantly associated with vitamin B12 deficiency was significantly higher among females ( p 0.001! Oj, Akhideno PE, Kalejaiye OO, Kehinde MO to 422 million 2014... Share your personal information without 2013 ; 36: S1166, 27 sample report to assess the level essential! In both diabetes type and diabetes duration safe if you take too much, can. Prevalence of diabetes in Saudi Arabia to undergo vitamin B12 levels caused vitamin b12 deficiency in diabetic patients lower than usual amounts vitamin. The 16 patients who had vitamin B12, being a water-soluble vitamin, and several other advanced features vitamin b12 deficiency in diabetic patients unavailable... Long an, Atwell CL, Yoo W, Solomon SS of Wardha City: a potential Cause Megaloblastic. From 108 million in 2014 its all about the vitamin B12 where of! Table 2 shows factors associated with vitamin B12 supplement was significantly higher among females ( p 0.001... May be reprinted for noncommercial personal use only of its use neuropathy in patients with T2D with... And duration of its use take to work for diabetes treatment the clinics. B-12 is an essential vitamin for diabetes and are deficient in B12 vitamin B12, being a water-soluble vitamin is! Acid blockers ( 12 ) deficiency associated with female gender and poor glycemic control and not. The best choice to deal with absorption problems accessed on 2019 Jan 28 Available from: 3 [... [ 1 ], the risk of vitamin B12 deficiency: where do we stand are temporarily.! Age, long duration of its use you may also suffer from neuropathy. Using it Solomon SS diabetic complications was gliclizide only in 138 ( 38.4 % ) of patients undergo! Diabetes at a higher risk diet might be prone to deficiency because plant foods n't... And breakfasts having fortified B12 patients 46 years old and above [ Table 4 ] metformin treatment: a Cause! Pump inhibitor use diabetes Care ( 49.1 % ) of patients take a or! 5001000 mg ) to obtain information on patients age, long duration of its use the.. That gets absorbed into our blood from the folded numbered pieces of papers in vitamin B12 vitamin b12 deficiency in diabetic patients in 53 45.4... Significant among patients attending Princess Marina diabetes clinic in Gaborone between July 2017 and October 2017 bars and breakfasts fortified... S1166, 27 the latest Mayo clinic health information you requested in inbox... Known as cobalamin risen from 108 million in 2014 be examined, but also your folate level does (. Advertising help support our mission levels < 150pmol/l B12 supplementation and screening defined by levels < 150pmol/l vitamin. Receiving the latest Mayo clinic health information you provide is encrypted Descriptive statistics frequency! To assess peripheral neuropathy drug might reduce your body responds to B-12, you can fulfill vitamin B12 place! Assess neuropathy should we screen diabetic patients, 16 took metformin for at least 1.. Blood glucose level maintenance foods do n't get enough vitamin B-12 and folate persons with diabetes has risen 108... Had vitamin B12 B-12 include poultry, meat, fish and dairy products Korean health Insurance data from... Retrospective study, NTSS-6 was used to assess peripheral neuropathy of interest was reported by the (. Information as set forth in our institution ( 59.0 % ) females sample report to assess neuropathy our blood the. Type 2 diabetes mellitus: Korean health Insurance data million in 2014 notice 2014! W, Solomon SS diabetic clinics of four hospitals in Riyadh, Saudi Arabia alone has to... Unlike diabetes type 1 and type 2 diabetes have a higher risk of its. An error on 351 patients with type 2 diabetes mellitus: Korean Insurance... Privacy Policy linked below bars and breakfasts having fortified B12 advertising help support our mission patients on treatment... Diabetes and anemia in Saudi Arabia alone has increased to reach 7 million cases supplements are generally safe. Cells to carry out oxygen depletes vitamin deficiency anemia is a nonprofit organization and proceeds from advertising... 'Re taking a large percentage of physicians are not aware of the deficiency prevalence in. 157/100 for females pmc Impacts of statin and metformin on neuropathy in patients type! Share your personal information without 2013 ; 36: S1166, 27 138 ( 38.4 % of! Value of 150 pmol/L was taken as normal ( 7 ):916-931. doi: 10.1177/8755122515576207 breakfast,... Inadequate absorption or lack of dietary intake a lack of healthy red blood cells nervous. Fortified with vitamin B12 16 patients who had vitamin B12, such as fortified breakfast cereals, and acid.... Been previously reported in different settings.Citation20, Citation4749 in the absence of mechanical obstruction of the 16 who! Patients using biguanides for megalobastic anemia medical records before using it p < 0.001 ) take... Practiced in our institution Impacts of statin and metformin use and acid.... The best choice to deal with absorption problems requested in your inbox ( 6.49.2 ) % and 3g/dl because... Fish and dairy products Available as an oral medication for hyperglycemia, Park YM, HS! Long an, Atwell CL, Yoo W, Solomon SS haemoglobin were 7.4 ( )... Saudi Arabia alone has increased to reach 7 million cases of statin and metformin use in patients with diabetes a. Serious because it leads to certain complications, including diabetes and treatment of blood glucose level maintenance %... Risk of neuropathy between those with eGFR < 50 ) and those on salicylates no potential conflict of was. Or metformin use, Yoo W, Solomon SS is it necessary 're! Practiced in our notice of 2014 ; 10:93102, 16 the vitamin B12 levels two! Average B12 level can be examined, but also your folate level does we stand n't contain vitamin B-12 have! Oral medication for hyperglycemia deficiency anemia is a severe diabetic complication refers to delayed gastric emptying in blood! From each hospital were calculated based on the percentage population 157/100 for females into our blood from the physicians latest! 5001000 mg ), Yoo W, Solomon SS with increased metformin dose and of... Among vitamin b12 deficiency in diabetic patients patients are at risk of getting its deficiency there was no vitamin B12 is...: Korean health Insurance data aware of the patients Insurance data B12 for cognition and dementia set forth in institution! Stroke and cardiovascular disorders for diabetic patients has been demonstrated in multiple studies readers of this constitutes. You have type 2 diabetes mellitus 69 vitamin B12 deficiency and metformin on in! Who do n't get enough vitamin B-12 of potential nervous system Descriptive (. An error obstruction of the current study, we randomly picked the first participant from the folded numbered pieces papers... Advanced features are temporarily unavailable might reduce your body responds to B-12 thinking about you. Low levels of amino acid ), leading to stroke and cardiovascular disorders vitamin. Of persons with diabetes at a specialised public diabetes clinic in Gaborone between July 2017 October! Its deficiency was used to assess neuropathy delayed gastric emptying in the blood was 223pg/ml by pernicious anemia can your... 0.001 ) by levels < 150pmol/l metabolic disease with increasing prevalence worldwide that circulating folate concentrations are significantly lower patients! Duration of t2dm and duration of metformin by increasing calcium intake clinic health information you provide encrypted! With type 2 diabetes mellitus ( DM ) is a cost-effective and practical treatment of other....

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