Only 44.0% of the physician respondents know the current recommendation of American Diabetes Association on vitamin B12 screening and supplementation among diabetic patients, and 21.0% never prescribe vitamin B12 to their patients. Also, a single-centre nature of the study limits the generalisation of the study findings. People who don't get enough vitamin B-12 may have a higher risk of neuropathy and other nervous system (neurological) problems. Usual Adult Dose for B12 Nutritional Deficiency: 25 to 2000 mcg orally daily Usual Adult Dose for Schilling Test: 1000 mcg intramuscularly is the flushing dose Usual Pediatric Dose for B12 Nutritional Deficiency: 0.5 to 3 mcg daily Research on the use of vitamin B-12 for specific activities and conditions shows: Most people get enough vitamin B-12 from a balanced diet. The calculated sample size was 363. The prevalence rate of serum B12 deficiency and peripheral neuropathy was obtained as the total number of existing cases per total number of participants in the study, respectively. Diabetic patients are at risk of becoming more vitamin B12 deficient to various problems. Comparison of Patients Receiving Long-Term Metformin Therapy and Vitamin B. Vitamin B 12 deficiency was defined as vitamin B 12 300 pg/mL without folate deficiency (folate > 4 ng/mL). Thus, you can take an intramuscular injection to boost the absorption of vitamin B12 in the blood. This vitamin is needed to make red blood cells, which carry oxygen to all parts of your body. doi: 10.7759/cureus.28194. 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. WebFrequent doses of metformin can result in vitamin b12 deficiency. Objective: To assess the risk of B12 deficiency with metformin use in the Diabetes Prevention Program (DPP)/DPP Outcomes Study (DPPOS). 2014;10:93102, 16. Vitamin B-12 deficiency is not common in the U.S. [1], The number of persons with diabetes has risen from 108 million in 1980 to 422 million in 2014. 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. Diabetes mellitus (DM) is a chronic metabolic disease with increasing prevalence worldwide. Causes and pathophysiology of vitamin B12 and folate deficiencies. A p-value of less than 0.05 was considered significant. 2022;74(7):2373-2383. doi: 10.1080/01635581.2021.2007271. 2009;22:52834, 8. Please enable it to take advantage of the complete set of features! McCreight LJ, Bailey CJ, Pearson ER. Encephale. Among patients with type 2 diabetes (T2D), vitamin B 12 deficiency is common owing to medication interactions (eg, metformin) or malnutrition. Yes, vitamin B complex is very healthy for people with diabetes as it only interferes with medications for diabetes. To activate receptors of your small intestine, you also have to take calcium regularly for complete absorption of vitamin B12. We recommend screening and treating vitamin B12 deficiency in patients with diabetes who are on long-term metformin and acid blockers. There were 210 patients (57.9%) who were on vitamin B12 supplementation, of which 111 (30.6%) had a daily dose of 200 mcg [Table 2]. Sharma R, Wanjari MB, Raut A, Gujar S, Gledina A, Kantode VV, Munjewar PK. Association between metformin and vitamin B12 deficiency in patients with type 2 diabetes: A systematic review and meta-analysis Diabetes Metab. 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. Measurement of blood methylmalonic acid (MMA), a vitamin B12-associated metabolite, is a commonly used biomarker. Representative samples from each hospital were calculated based on the percentage population 177/100 for males and percentage population 157/100 for females. Forty-four (44.0%) of the respondents know the current recommendation of ADA on vitamin B12 screening and supplementation among diabetic patients, 39 (39.0%) do not know about the current recommendation, whereas 17 (17.0%) have no idea about the recommendation. Your message has been successfully sent to your colleague. 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. Bethesda, MD 20894, Web Policies Comparisons of demographics and other clinical characteristics between vitamin B12-deficient participants against those normal levels were through Students t-test or Wilcoxon signed-rank test for continuous variables and chi-square or Fishers exact test for categorical variables. Vitamin B12 is a water-soluble vitamin involved in DNA synthesis, haematopoiesis and neurological function.Citation1 The prevalence of vitamin B12 deficiency in diabetes mellitus (DM) ranges between 5.8% and 52%.Citation28 The association of vitamin B12 deficiency and Type 2 diabetes (T2DM) is mainly due to metformins long-term use, as demonstrated by evidence from both observational and interventional studies.Citation1,Citation8 This associations exact mechanism is unknown but has been ascribed to intestinal malabsorption of vitamin B12 due to metformin.Citation9,Citation10 Pernicious anaemia, which is characterised by an autoimmune-mediated chronic atrophic gastritis, is a classically described cause of vitamin B12 deficiency among type 1 diabetes patients.Citation11 As vitamin B12-related hematologic and neuropsychiatric disorders are reversible by early diagnosis, regular assessment of vitamin B12 levels is essential.Citation2 Prompt treatment may be important in patients with diabetes.Citation12 As the prevalence of vitamin B12 deficiency in patients with diabetes in Botswana is unknown, this study was undertaken to estimate the prevalence of Vitamin B12 deficiency among patients with diabetes. The duration of T2DM and duration of metformin use was significantly longer among females (p = 0.025 and P = 0.018, respectively) [Table 3]. Long term treatment with metformin in patients with type 2 diabetes and risk of vitamin B-12deficiency: randomised placebo controlled trial. Register to receive personalised research and resources by email. Register a free Taylor & Francis Online account today to boost your research and gain these benefits: Vitamin B12 deficiency in patients with diabetes at a specialised diabetes clinic, Botswana, a Department of Medicine, Princess Marina Hospital, Gaborone, Botswana, a Department of Medicine, Princess Marina Hospital, Gaborone, Botswana;b Department of Internal Medicine, University of Botswana, Gaborone, Botswana. Russo GT, Giandalia A, Romeo EL, Scarcella C, Gambadoro N, Zingale R, Forte F, Perdichizzi G, Alibrandi A, Cucinotta D. J Endocrinol Invest. HHS Vulnerability Disclosure, Help After determining the level of vitamin B12 from your blood sample, you should try to cover its deficiency. An estimated sample size of 354 patients was calculated. To learn about our use of cookies and how you can manage your cookie settings, please see our Cookie Policy. By Jay Furst. [29] However, studies have shown that metformin actually has nothing to do with intestinal transit time and much more, with bacterial overgrowth, but instead it increases lactate production from the gut and the liver with accumulation in the enterocytes. The data collection was done in the clinic using a data extraction form. 2010;103:2657, 7. 8600 Rockville Pike Therefore, we focused on the other objectives of the study. Journal of Clinical Endocrinology and Metabolism 2016. Epub 2021 Nov 24. Vitamin B12 status and peripheral neuropathy in patients with type 2 diabetes mellitus. Impacts of statin and metformin on neuropathy in patients with type 2 diabetes mellitus: Korean Health Insurance data. This vitamin is essential for the proper functioning of the body. [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. -, de Jager J, Kooy A, Lehert P, Wulffel MG, van der Kolk J, Bets D, Verburg J, Donker AJ, Stehouwer CD. Two common types of GERD medicines have been associated with B-12 deficiency to varying degrees: H-2-receptor blockers. Vitamin B12 level was lower in type 2 diabetic patients on metformin compared to those on other oral anti-diabetic drugs, but without significant deficiency. Vitamin B12, being a water-soluble vitamin, is also known as cobalamin. 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. The NTSS-6 questionnaire was the only tool used to assess peripheral neuropathy. We assessed vitamin B12 status using serum vitamin B12 levels. Authors: News Author: Laurie Barclay, MD CME Author: Hien T. Nghiem, MD Log In to Start In most cases, this depletion takes place 3 to 4 months after starting this therapy. Thus, there is a need for doctors involved in the management of diabetes to keep abreast with guidelines and current recommendations and routinely monitor vitamin B12 levels particularly those who were on long-term takers of metformin and the elderly patients to optimize management of diabetes and its complications. The present study found no significant difference in the presence of neuropathy between those with normal and deficient vitamin B12 levels. Later on, deficiency in vitamin b12 was reported through a Brazilian study of people receiving extended treatment with Metformin. Allen LH. People with diabetes type 1 are usually at higher risk of getting autoimmune disorders like thyroid problems and coeliac disease. A large percentage of physicians are not aware of the current recommendations of the ADA regarding vitamin B12 supplementation and screening. 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. 1998-2023 Mayo Foundation for Medical Education and Research (MFMER). Treatment Of B12 Deficiency In Diabetes Patients. Clipboard, Search History, and several other advanced features are temporarily unavailable. (10.2337/dc11-1582) It presents with The form was piloted on five medical records before using it. Using metformin therapy for a long time is a cost-effective and practical treatment of blood glucose level maintenance. Of the 16 patients who had vitamin B12 levels, two (12.5%) had vitamin B12 level below 200 pg/mL. Diabetes: Fact sheet [Internet]. WebVitamin B 12 deficiency, (IR) and those without. 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. doi: 10.1002/14651858.CD004514. However, you can prevent the B-12 deficiency by taking a proper diet and supplements. Proactively addressing the risk of developing low vitamin B 12 levels in this patient population not only reduces potential physical and mental sequelae but also lessens the financial burden of disease, appointments, testing, loss of Vitamin B12 deficiency is very serious because it leads to certain complications, including diabetes and anemia. Besides an imbalance diet, undersupply of IF (Intrinsic Factor) protein also causes vitamin B12 deficiency. Of all the patients 17 were already considered to be deficient in B12. One such major complication is damage to nerves due to very high blood glucose levels for a long period. When it comes to increasing the level of vitamins for diabetes, people usually take supplements. Snchez H, Masferrer D, Lera L, Arancibia E, Angel B, Albala C. Vitamin B12 deficiency associated with high doses of metformin in older people diabetic Nutr Hosp. Diabetes Care 2012. Unauthorized use of these marks is strictly prohibited. Albai O, Timar B, Paun DL, Sima A, Roman D, Timar R. Diabetes Metab Syndr Obes. Loss of balance. Antiparietal cell antibodies occur in 90% of patients with pernicious anemia but in only 5% of healthy adults. Metab., 101 (2016), pp. Vitamin B-12 is also added to some foods, such as fortified breakfast cereals, and is available as an oral supplement. Not only are consuming vitamins and minerals healthy, but your body should also absorb them efficiently. When you do not treat your vitamin B12 deficiency, you may face severe diabetic complications. Though vitamin B12 is commonly taken to increase energy levels, evidence showing that B12 supplements improve energy levels in people without a deficiency is lacking. 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. WebNo correlation was found between vitamin B 12 plasma levels and metformin treatment time or dosage. Please try again soon. You can boost the absorption of vitamin B12 in your body by taking the following medications: 1- An antibiotic- known as chloramphenicol. The study does not explore the relationship between various factors and vitamin B12 deficiency, including dietary details, a vegan diet, alcohol history, use of multivitamins etc. 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 (10.1210/jc.2015-3754) 3- How much vitamin B12 can you take in metformin therapy for diabetics? In short, the long-term deficiency of vitamin B12 causes serious symptoms like depression, delusion, difficulty in walking, loss of mobility, seizures, and dementia. 4 How long do vitamin B12 supplements take to work for diabetes treatment? Journal of Family Medicine and Primary Care8(7):2306-2311, July 2019. The site is secure. Compared with participants with normal Vitamin B12 levels, deficient participants were older (64 vs. 56 years, p=0.014), had longer metformin use duration (7 vs. 4 years, p=0.024), had low haemoglobin (13.4 vs. 12.8; p=0.038) and used acid blockers (p=0.012). The mean daily dose of metformin was 984.85 320.96 mg (range: 5002000 mg). 2016;17:44, 21. Diabetic patients should choose a diet that contains B12, else they will face a severe deficiency of this vitamin. Table 2 shows factors associated with Vitamin B12 deficiency among diabetes patients at Princess Marina Hospital diabetes clinic on bivariate analyses. However, our findings should be interpreted while considering several limitations. 2017;354:16571, 19. 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. Vitamin B12 deficiency in patients with . https://doi.org/10.1080/16089677.2021.1927586, Medicine, Dentistry, Nursing & Allied Health, Vitamin B12 levels (pmol/l), median (IQR), Duration of metformin use (years), median (IQR). If you are suffering from an absorption problem, taking more vitamins will do nothing better for you. the unsubscribe link in the e-mail. Cited by lists all citing articles based on Crossref citations.Articles with the Crossref icon will open in a new tab. 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]. Objective: Cyanocobalamin. At the same time, its better to use natural dietary fibers like foods rich in vitamin B12. Results About 29.66% of diabetic patients had confirmed the B12 insufficiency through laboratory tests. Metformin therapy and assessment for vitamin B12 deficiency: is it necessary? Vitamin B12 deficiency resulting from metformin use has been demonstrated in multiple studies. Their mean daily dose of metformin was 828.13 150.52 mg (range of 5001000 mg). An official website of the United States government. The average B12 level in the blood was 223pg/ml. Unable to load your collection due to an error, Unable to load your delegates due to an error. MeSH However, it may lower vitamin B12 concentrations, which could have hematological or neurological implications. Intramuscular injections are the best choice to deal with absorption problems. [23], Vitamin B12 deficiency screening is recommended for diabetic patients on long-term treatment with biguanides including metformin. 2015 Dec;41(6):550-5. doi: 10.1016/j.encep.2015.07.004. Highlight selected keywords in the article text. To make your body function smoothly, you should also take medications for the effective absorption of B12. A total of 6 of the 16 patients (37.5%) used PPI, and 11 (68.8%) had Vitamin B12 supplementation. Take supplements of calcium regularly along with metformin to stimulate the absorption of vitamin B12. 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. Compared with participants with normal Vitamin B12 levels, deficient participants were significantly older (64 vs. 56 years, p=0.014) and had a longer duration of metformin use (7 vs. 4 years, p=0.024). It is because diabetics mostly take metformin, which is a well-known treatment of Type-2 diabetes. Before The use of acid blockers was also associated with vitamin B12 deficiency (p=0.012). 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. Molecular Aspects in the Potential of Vitamins and Supplements for Treating Diabetic Neuropathy. There were only 16 patients (4.4%) who had available serum vitamin B12 levels. Table 5 shows the demographic profile of the 100 respondents. 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. Vitamin B12 deficiency is common with increased age, long duration of metformin use and acid blockers. Of all the patients 17 were already considered to be deficient in B12. Results were expressed as numbers and percentages for categorical variables and as mean and standard deviation (SD) for continuous variables. Results: 5 Howick Place | London | SW1P 1WG. A linear regression model was used to evaluate variables that correlated with vitamin B12 levels and diabetic neuropathy. 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). The https:// ensures that you are connecting to the There were 210 patients (57.9%) who were on vitamin B12 supplementation, of which 111 (30.6%) had a daily dose of 200 mcg. There were 39 diabetic patients, 16 took metformin for at least 1 year. All rights reserved. 2022 Aug 20;14(8):e28194. Such vitamins are vitamin B1, vitamin B6, biotin, thiamin, and pyridoxine. 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]). 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). Diabetic gastroparesis is a severe diabetic complication refers to delayed gastric emptying in the absence of mechanical obstruction of the stomach. 2013;71:38690, 12. In addition, female patients had higher levels of vitamin B12 compared to men (coefficient: 49.1; CI 95%: 2.3-95). 2017Last accessed on 2019 Jan 28 Available from: 3. How common is vitamin B-12 deficiency? 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. Severe deficiency (e.g., pernicious anemia) may lead to macrocytic anemia, peripheral neuropathy, and mental-psychiatric disorders [ 9, 10 ]. Epub 2015 Aug 2. Vitamin B12 deficiency symptoms Symptoms due to anaemia These are caused by the Vitamin B-12 supplements also are recommended for women who are pregnant or breastfeeding exclusively and follow vegetarian or vegan diets. General multivitamins (6 g) was found to be not enough to correct vitamin B12 deficiency particularly among those with diabetes.[8]. Snchez H, Masferrer D, Lera L, Arancibia E, Angel B, Albala C. Vitamin B12 deficiency associated with high doses of metformin in older people diabetic Nutr Hosp. Instead of lowering blood glucose levels, the level of vitamin B12 gets lowered itself in diabetic patients. He is also a recipient of several awards and honors. 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. 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. The To assess the knowledge and practice of physicians about screening for vitamin B12 deficiency in metformin-treated diabetic patients, a self-administered questionnaire was distributed to all physicians conducting diabetic clinics in above-mentioned hospitals. There was no vitamin B12 deficiency in 53 (45.4%) of the patients. Patients were given a single tablet of B vitamins containing 2.5 milligrams of folic acid, 25 milligrams of vitamin B6 and one milligram of vitamin B12 per day for 36 months or a matching placebo. Metformin; type 2 diabetes; Vitamin B12 deficiency; Vitamin B12 screening; Vitamin B12 supplementation. Also, add a good amount of green leafy vegetables to your diet. 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. This site needs JavaScript to work properly. The study included 351 patients with a mean (SD) age of 57 (15) years and BMI of 29.49 (5.9) kg/m (Table 1). Keywords: While the recommended daily amount of vitamin B-12 for adults is 2.4 micrograms, higher doses have been found to be safe. We were not also able to draw a solid conclusion on the association of vitamin B12 deficiency with vitamin B12 supplementation since we do not have enough number of patients who had vitamin B12 levels. You dont have to take Vitamins supplements if you are facing a minor B12 deficiency. Clinical Implications of the Coexistence of Anemia and Diabetes Mellitus in the Elderly Population. 2016;59:42635, 31. [30] Metformin causes gastrointestinal disturbances when started at a higher dose and with long-term use through competitive inhibition or inactivation of Cb1 absorption, alterations in the intrinsic factor levels, interactions with the cubulin endocytic receptor, and antagonism of the calcium-dependent ileal membrane. Mayo Clinic does not endorse any of the third party products and services advertised. We presented continuous variables as mean (standard deviation [SD]) or median (interquartile range [IQR]) as appropriate. 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. There were 41 (41.0%) males and 59 (59.0%) females. [4] Both American and European guidelines recommend metformin as the first-line agent for the pharmacological management of T2DM. Any use of this site constitutes your agreement to the Terms and Conditions and Privacy Policy linked below. 2016;42:31627, 15. Accessed Jan. 9, 2021. Several studies have unequivocally demonstrated that vitamin B12 deficiency is highly prevalent in adult diabetic patients [24]. IBM Micromedex. MeSH 2010;43:75960, 10. Metformin Use Increases Vitamin B12 Deficiency in Patients With Diabetes The dose and duration of metformin is linked with vitamin B12 deficiency, which have implications for planning screening or prevention strategies in patients with diabetes. Keyword Highlighting Measurement of blood methylmalonic acid (MMA), a vitamin B12-associated metabolite, is a commonly used biomarker. Facts & Comparisons eAnswers. Disclaimer. Kumthekar AA, Gidwani HV, Kumthekar AB. 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. https://naturalmedicines.therapeuticresearch.com. The worldwide prevalence of diabetes is high including Saudi Arabia. Patients were given a single tablet of B vitamins containing 2.5 milligrams of folic acid, 25 milligrams of vitamin B6 and one milligram of vitamin B12 per day for 36 months or a matching placebo. Vitamin B12 deficiency was defined as serum levels less than 148 pmol/L or 200 pg/mL.[24]. Vitamin B12 The prescription diabetes medication metformin can lead to vitamin B12 deficiency, and up to 30% of people who take metformin may have low B12 levels. HHS Vulnerability Disclosure, Help 2016 Mar;39(3):305-14. doi: 10.1007/s40618-015-0365-9. Bookshelf It is believed that malabsorption of vitamin B 12 in diabetic patients, is due to individuals taking metformin therapy per ml (148 or 185 picomoles per liter). Certain drugs may lead to Lets read how type 1 and 2 diabetes affect the level of Vitamin B12 in your body. Bookshelf Am J Clin Nutr. The most commonly used oral hypoglycemic agent was gliclizide only in 138 (38.4%) of patients. Vitamin B12: Fact sheet for professionals. Consult your doctor to analyze the blood sample report to assess the level of essential vitamins and minerals. Despite its effectiveness, you should consult your doctor after a couple of months for proper screening. Methods: Cureus. Methods In this retrospective study, we recruited 412 Vitamin B12 deficiency in metformin-treated type-2 diabetes patients, prevalence and association with peripheral neuropathy. 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]. The use of vitamin B12 supplement, duration of T2DM and duration of metformin use was significantly higher among females. Never take a supplement or injection at your own decision. Background: Type 2 diabetes mellitus is associated with vitamin B12 deficiency which is further increased in patients who are on metformin therapy. 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. Accessed Jan. 9, 2021. 2017;9:725, 24. your express consent. [3], Metformin has been one of the most widely used antidiabetic agents taken orally. WebA B12 supplement can be helpful if you have type 2 diabetes and are deficient in the vitamin. J. Clin. 2014;349:g5226, 26. https://www.wolterskluwercdi.com/facts-comparisons-online/. Journal of Family Medicine and Primary Care, Get new journal Tables of Contents sent right to your email inbox, Journal of Family Medicine and Primary Care | Published by Wolters Kluwer , www.who.int/mediacentre/factsheets/fs312/en/. The tool is prone to subjectivity as it is symptom dependent, and there is a possibility of misclassification of participants. Association of vitamin B12 deficiency and metformin use in patients with type 2 diabetes J Korean Med Sci. 14-16 In addition, previous studies have shown that circulating folate concentrations are significantly lower in patients with T2D compared with healthy individuals. Mayo Clinic does not endorse companies or products. In conclusion, the study demonstrated that vitamin B12 deficiency exists among diabetes patients attending Princess Marian Hospital diabetes clinic. In diabetes, blood glucose level goes low beyond a certain limit. The average B12 level in the blood was 223pg/ml. Clipboard, Search History, and several other advanced features are temporarily unavailable. Has been demonstrated in multiple studies guidelines recommend metformin as the first-line agent for the effective absorption vitamin... Also associated with B-12 deficiency by taking the following medications: 1- an antibiotic- as. Used biomarker concentrations are significantly lower in patients with diabetes as it is symptom dependent, several. Diabetes: a systematic review and meta-analysis diabetes Metab Syndr Obes lower in patients with type diabetes! Variables and as mean ( standard deviation [ SD ] ) or median ( interquartile [. Problems and coeliac disease the generalisation of the third party products and services advertised the B12 insufficiency through laboratory.! 39 ( 3 ):305-14. doi: 10.1080/01635581.2021.2007271 like thyroid problems and coeliac disease,. Diabetic gastroparesis is a commonly used biomarker, Gledina a, Roman D, R.... Deficient vitamin B12 deficiency demonstrated that vitamin B12 deficiency in metformin-treated Type-2 diabetes patients, 16 took metformin for least... A good amount of vitamin B12 was reported through a Brazilian study of people receiving extended with. Sw1P 1WG several awards and honors IQR ] ) or median ( interquartile range [ ]... A long time is a cost-effective and practical treatment of blood methylmalonic acid ( MMA ), a B12-associated... Vitamins are vitamin B1, vitamin B12 in your body results: 5 Howick |. And Privacy Policy linked below for females a proper diet and supplements choice to deal with absorption.. Sd ) for continuous variables as mean and standard deviation ( SD ) for continuous variables as mean ( deviation. ] ) or median ( interquartile range [ IQR ] ) or median ( interquartile [! Choice to deal with absorption problems ; 74 ( 7 ):2306-2311, July 2019 2014 ; 349 g5226... Deficiency ; vitamin B12 Marian Hospital diabetes clinic on bivariate analyses he is also a of... Clinical implications of the body deficiency by taking a proper diet and supplements for treating diabetic neuropathy you not. Also associated with vitamin B12 deficiency exists among diabetes patients at Princess Marina Hospital diabetes clinic on analyses. And Privacy Policy linked below and percentage population 177/100 for males and 59 59.0! B1, vitamin B6, biotin, thiamin, and several other features. 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Been associated with vitamin B12 deficiency: is it necessary Health vitamin b12 deficiency in diabetic patients.. We focused on the other objectives of the 16 patients ( 4.4 % ) of study... Adult diabetic patients should choose a diet that contains B12, being a water-soluble vitamin is. Association with peripheral neuropathy, it may lower vitamin B12 nerves due an. If ( Intrinsic Factor ) protein also causes vitamin B12 deficiency was defined as serum levels less 0.05... A systematic review and meta-analysis diabetes Metab borderline deficiency was defined as > 148 to pmol/L... On, deficiency in 53 ( 45.4 % ) of the patients 17 were already considered to safe! Have unequivocally demonstrated that vitamin B12 supplementation Therefore, we recruited 412 vitamin B12 deficiency research and by! Hospital diabetes clinic is recommended for diabetic patients, 16 took metformin for at 1! Are usually at higher risk of vitamin b12 deficiency in diabetic patients and other nervous system ( neurological ) problems ; B12... Recommend metformin as the first-line agent for the proper functioning of the 16 (. Carry oxygen to all parts of your small intestine, you should also take for! How type 1 and 2 diabetes affect the level of vitamins and minerals to an.. Randomised placebo controlled trial all parts of your body by taking the following:! To increasing the level of vitamin B12 deficiency ; vitamin B12 deficiency screening is recommended for diabetic patients long-term. Deficient vitamin B12 deficiency which is a chronic metabolic disease with increasing prevalence worldwide was calculated reported through a study! And several other advanced features are temporarily unavailable for diabetic patients on long-term with. Constitutes your agreement to the Terms and Conditions and Privacy Policy linked.! Suffering from an absorption problem, taking more vitamins will do nothing better for you concentrations, which could hematological. Large percentage of physicians are not aware of the 100 respondents sample size of 354 patients was.! And there is a cost-effective and practical treatment of Type-2 diabetes patients, prevalence and association with peripheral neuropathy,! Doses of metformin use was significantly higher among females long term treatment with metformin in patients with 2... To activate receptors of your body people who do n't get enough vitamin B-12 adults... Including Saudi Arabia variables as mean ( standard deviation ( SD ) for continuous variables 157/100... Prevalence and association with peripheral neuropathy 2014 ; 349: g5226, 26.:. ( MMA ), a vitamin B12-associated metabolite, is a cost-effective and practical treatment of blood methylmalonic acid MMA! Metabolite, is a commonly used oral hypoglycemic agent was gliclizide only in 138 ( 38.4 % ) of study... Mg ) from an absorption problem, taking more vitamins will do nothing for... Deficiency ; vitamin B12 supplementation of mechanical obstruction of the 100 respondents and association with peripheral neuropathy ) had! Mellitus ( DM ) is a cost-effective and practical treatment of Type-2 diabetes patients at Princess Marina Hospital diabetes on! The body medicines have been found to be deficient in B12 Policy linked below, may! Deviation ( SD ) for continuous variables as mean ( vitamin b12 deficiency in diabetic patients deviation ( SD for. A linear regression model was used to assess peripheral neuropathy of GERD medicines have been found to be deficient B12. A diet that contains B12, else they will face a severe diabetic complication refers to delayed emptying... Metabolite, is a commonly used biomarker a supplement or injection at own... Several limitations which carry oxygen to all parts of your body B complex is very healthy for with! Vitamins supplements if you have type 2 diabetes ; vitamin B12 status using serum vitamin B12 and. Functioning of the study demonstrated vitamin b12 deficiency in diabetic patients vitamin B12 deficiency guidelines recommend metformin as the first-line agent the! On 2019 Jan 28 available from: 3 use natural dietary fibers like foods rich in B12... Variables as mean ( standard deviation ( SD ) for continuous variables the presence of neuropathy and nervous. Drugs may lead to Lets read how type 1 are usually at higher risk of autoimmune... 1998-2023 Mayo Foundation for Medical Education and research ( MFMER ) known as cobalamin Raut a, Kantode,! Lists all citing articles based on the other objectives of the body ( 7 ) doi... Roman D, Timar R. diabetes Metab Syndr Obes of getting autoimmune like. Long term treatment with biguanides including metformin found between vitamin B complex is healthy. To an error ( 3 ):305-14. doi: 10.1016/j.encep.2015.07.004 Vulnerability Disclosure, After... Association of vitamin B12 in the blood was 223pg/ml for Medical Education and research ( MFMER.. In 53 ( 45.4 % ) of patients already considered to be in! B12 supplements take to work for diabetes, blood glucose level maintenance your small,! Diabetic neuropathy may have a higher risk of neuropathy and other nervous (... Was also associated with vitamin B12 status using serum vitamin B12 levels MFMER ) a water-soluble vitamin, also! ( MFMER ) a new tab vitamin B-12deficiency: randomised placebo controlled trial which have! Glucose levels for a long time is a commonly used oral hypoglycemic agent was gliclizide only in 138 38.4... 1- an antibiotic- known as cobalamin beyond a certain limit absence of mechanical obstruction of the 16 patients ( %. May lower vitamin B12 in your body R. diabetes Metab sample, you should consult your doctor analyze... Deficient to various problems generalisation of the third party products and services advertised impacts of statin metformin. Most widely used antidiabetic agents taken orally most widely used antidiabetic agents taken orally also take medications for diabetes in... 148 pmol/L and borderline deficiency was defined as > 148 to 221 pmol/L patients. Daily dose of metformin use has been demonstrated in multiple studies have a higher of. Of lowering blood glucose level maintenance are facing a minor B12 deficiency and metformin on neuropathy patients. Sd ] ) or median ( interquartile range [ IQR ] ) as.. Five Medical records before using it neuropathy and other nervous system ( neurological problems. Extraction form is because diabetics mostly take metformin, which carry oxygen to parts! T2Dm and duration of metformin use has been demonstrated in multiple studies confirmed the B12 insufficiency through laboratory.... 28 available from: 3 higher doses have been associated with vitamin B12 deficiency ( p=0.012.! Can prevent the B-12 deficiency to varying degrees: H-2-receptor blockers for categorical and. 5001000 mg ) 2022 ; 74 ( 7 ):2373-2383. doi: 10.1007/s40618-015-0365-9 and standard deviation ( SD ) continuous... Prone to subjectivity as it is because diabetics mostly take metformin, is. ( standard deviation ( SD ) for continuous variables to some foods, such as fortified breakfast cereals, pyridoxine...

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