vitamin b12 deficiency in diabetic patients

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. IBM Micromedex. 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. Metformin is the base of medicine in the treatment of type 2 diabetes mellitus (T2DM) with estimates that it is frequently approved and recommended to 120 million patients with diabetes globally. Wolters Kluwer Health https://www.wolterskluwercdi.com/facts-comparisons-online/. Mayo Clinic offers appointments in Arizona, Florida and Minnesota and at Mayo Clinic Health System locations. 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. Methylmalonic acid and homocysteine tests are unavailable in our setting due to their high costs. The questionnaire contained questions on their demographic profile, knowledge and practice of screening of Vitamin B12 level. Vitamin B12 deficiency is highly prevalent, especially in patients with diabetic neuropathy. The use of vitamin B12 supplement was significantly higher among females (p < 0.001). 2016;17:44, 21. You'll soon start receiving the latest Mayo Clinic health information you requested in your inbox. Data was collected from the medical records of four tertiary MoH hospitals in Riyadh, Saudi Arabia (King Salman Hospital, King Saud Medical City, Prince Mohammed Bin Abdul-Aziz Hospital and Imam Abdurrahman Alfaisal Hospital). 2021 Jul 9;12:711244. doi: 10.3389/fmicb.2021.711244. Accessed Jan. 9, 2021. Not feeling as hungry as usual. Please try again soon. 2016;134:4739, 22. Categorical variables appear as counts and percentages. 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. WebVitamin B12 is a water-soluble vitamin involved in DNA synthesis, haematopoiesis and neurological function. This content does not have an Arabic version. Irritability. A total of 6 of the 16 patients (37.5%) used PPI, and 11 (68.8%) had Vitamin B12 supplementation. Disclaimer. [25] There have been no studies that explored the knowledge and perceptions of physicians on vitamin B12 screening. Journal of Korean Medical Science 2014. A study shows that vitamin B12 increases due to the inductive effect of metformin by increasing calcium intake. 2006;35:2001, 6. 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. Table 1: Baseline characteristics of patients with diabetes at Princess Marina hospital diabetes clinic, between July 2017 and October 2017 (n=351). This site needs JavaScript to work properly. . Vitamin B12 deficiency is then easily missed. Methods: Please enable it to take advantage of the complete set of features! The PubMed wordmark and PubMed logo are registered trademarks of the U.S. Department of Health and Human Services (HHS). Well, you can fulfill vitamin B12 intake through energy bars and breakfasts having fortified B12. 2017;354:16571, 19. WebVitamin B12 deficiency is highly prevalent, especially in patients with diabetic neuropathy. Vitamin B12 affects the dynamics of autonomic nervous system and its deficits has been linked to cardiovascular autonomic neuropathy therefore, vitamin B12 deficiency was 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. The duration of metformin use is dependent on the patients history and thus subject to recall bias. There is a problem with J Pharm Technol. We excluded pregnant women and those with partial or total gastrectomy, colectomy, inflammatory bowel diseases and pernicious anaemia. 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. The .gov means its official. (10.1136/bmj.c2181) This can happen if you don't eat 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. Journal of Family Medicine and Primary Care8(7):2306-2311, July 2019. The high consumption of meat among the Botswana population may explain the lower prevalence of vitamin B12 in our population than in other African settings. Methods In this retrospective study, we recruited 412 [3], Metformin has been one of the most widely used antidiabetic agents taken orally. Bell DS. [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. Associations between B12 deficiency and age, duration of type 2 diabetes mellitus (T2DM), duration of use and dosage of metformin, and use of proton pump inhibitors (PPIs) were determined. Registered in England & Wales No. 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. The calculated sample size was 363. [23], Vitamin B12 deficiency screening is recommended for diabetic patients on long-term treatment with biguanides including metformin. RESULTS Biochemical B 12 deficiency was present in 5.8% of those with diabetes using metformin compared with 2.4% of those not using metformin ( P = 0.0026) and 3.3% of those General multivitamins (6 g) was found to be not enough to correct vitamin B12 deficiency particularly among those with diabetes.[8]. For more information, please refer to our Privacy Policy. When vitamin B12 does not reach the small intestine, it will not be absorbed properly, causing vitamin B12 deficiency. It presents with diverse clinical manifestations ranging from impaired memory, dementia, delirium, peripheral neuropathy, sub acute combined degeneration of the spinal cord, megaloblastic anemia and pancytopenia. Low vitamin B12 levels were found in 7.3% (95% CI: 4.0-12%) of patients. There are some limitations of this current study. information is beneficial, we may combine your email and website usage information with Keywords: Cobalamin Diabetes mellitus Metformin 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]. However, our findings should be interpreted while considering several limitations. You may also suffer from diabetic neuropathy due to a lack of vitamin B12. 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). We assessed vitamin B12 status using serum vitamin B12 levels. Office of Dietary Supplements. Of the 16 patients who had vitamin B12 levels, two (12.5%) had vitamin B12 level below 200 pg/mL. There were 39 diabetic patients, 16 took metformin for at least 1 year. Niafar M, Hai F, Porhomayon J, Nader N. The role of metformin on vitamin B12 deficiency: A meta-analysis review Intern Emerg Med. -, Ko SH, Ko SH, Ahn YB, Song KH, Han KD, Park YM, Ko SH, Kim HS. A p-value of less than 0.05 was considered significant. The most commonly used oral hypoglycemic agent was gliclizide only in 138 (38.4%) of patients. 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 study included 351 patients with a mean (SD) age of 57 (15) years and BMI of 29.49 (5.9) kg/m (Table 1). 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. This outpatient cross-sectional study found 6.6% of patients with diabetes at Princess Marina Hospital diabetes clinic to be vitamin B12 deficient. Vieira IH, Barros LM, Baptista CF, Rodrigues DM, Paiva IM. Subsequently, every fifth patient in the clinic attendees was selected until the days desired sample size was reached. The site is secure. Though all vegetables and plants dont have vitamin B12, there are still some plant-based sources. The overall median (IQR) HbA1c and haemoglobin were 7.4 (6.49.2) % and 3g/dl. (10.3346/jkms.2014.29.7.965) Vitamin B-12 supplements also are recommended for women who are pregnant or breastfeeding exclusively and follow vegetarian or vegan diets. The objective of this study is to determine the frequency of vitamin B12 deficiency among Indian patients with type 2 diabetes mellitus on metformin therapy compared to those who are You can obtain it through meat, poultry, fish, and dairy products. Vitamin B12 deficiency is highly prevalent, especially in patients with diabetic neuropathy. 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. Molecular Aspects in the Potential of Vitamins and Supplements for Treating Diabetic Neuropathy. You may opt-out of email communications at any time by clicking on Due to deficiency of B12 vitamin, the level of blood glucose decreases. Facts & Comparisons eAnswers. If you face a serious problem maintaining glucose, taking a vitamin B12 injection for almost 3 months will help you bring things in balance. 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