official website and that any information you provide is encrypted An estimated sample size of 354 patients was calculated. The use of vitamin B12 supplement was significant among patients 46 years old and above [Table 4]. WebA B12 supplement can be helpful if you have type 2 diabetes and are deficient in the vitamin. 327333. Some error has occurred while processing your request. 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 Certain drugs may lead to Disclaimer. We conducted a cross-sectional study among patients attending Princess Marina diabetes clinic in Gaborone between July 2017 and October 2017. 2012;19:936. Not feeling as hungry as usual. Min HK, Kim SH, Choi JH, Choi K, Kim HR, Lee SH. People usually take this vitamin along with folate and other vitamin B complexes. government site. No potential conflict of interest was reported by the author(s). Articles in Google Scholar by Amal N. Alshammari, Other articles in this journal by Amal N. Alshammari, Privacy Policy (Updated December 15, 2022). You may also suffer from diabetic neuropathy due to a lack of vitamin B12. (10.2337/dc11-1582) IBM Micromedex. Metformin Treatment: A Potential Cause of Megaloblastic Anemia in Patients with Type 2 Diabetes Mellitus. The definition of anemia: what is the lower limit of normal of the blood hemoglobin concentration? 1 The prevalence of vitamin B12 deficiency in diabetes mellitus In this study, we aimed to evaluate the prevalence of vitamin B12 deficiency in patients with chronic metformin use and the relationship between vitamin B12 deficiency and diabetic neuropathy. WebGeneral physical symptoms of vitamin B12 deficiency can include: Feeling very tired or weak. Vitamin B12 deficiency is a common condition that can manifest with neurological, psychiatric, and haematological disorders. Through this, not only your vitamin B12 level can be examined, but also your folate level does. other information we have about you. 2012;122:25370, 5. It depicts that vitamin B12 absorption is a calcium-dependent process. 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. 2009;22:52834, 8. Also, add a good amount of green leafy vegetables to your diet. Molecular Aspects in the Potential of Vitamins and Supplements for Treating Diabetic Neuropathy. 2019 May 23;7:2050312119853433. doi: 10.1177/2050312119853433. There was no vitamin B12 deficiency in 53 (45.4%) of the patients. [1], The number of persons with diabetes has risen from 108 million in 1980 to 422 million in 2014. The prevalence of vitamin B12 deficiency was 6.6%. Haeusler S, Parry-Strong A, Krebs JD. To learn about our use of cookies and how you can manage your cookie settings, please see our Cookie Policy. Table 5 shows the demographic profile of the 100 respondents. MeSH WebFrequent doses of metformin can result in vitamin b12 deficiency. Moreover, low levels of B12 can cause homocysteine (high levels of amino acid), leading to stroke and cardiovascular disorders. The Steno Diabetes Routine testing for serum vitamin B12 level is not practiced in our institution. Avoid drinking goat milk because its low in folate and vitamin B12. Chapman L, Darling A, Brown J. 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. Association of vitamin B12 deficiency and metformin use in patients with type 2 diabetes. Vitamin B12 levels were checked in all the patients and value of 150 pmol/L was taken as normal. Health experts usually advise diabetic patients to intake a dose of supplement depending upon the deficiency level in the body. The questionnaire contained questions on their demographic profile, knowledge and practice of screening of Vitamin B12 level. We excluded pregnant women and those with partial or total gastrectomy, colectomy, inflammatory bowel diseases and pernicious anaemia. By Jay Furst. It is because diabetics mostly take metformin, which is a well-known treatment of Type-2 diabetes. The use of vitamin B12 supplement, duration of T2DM and duration of metformin use was significantly higher among females. The median (IQR) duration since the diagnosis of diabetes was 6 (212) years, and 89.5% of participants were on 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 Find out what works best for you with this 60-sec expert-approved quiz and get your Klinio app. There were 39 diabetic patients, 16 took metformin for at least 1 year. 2014;29:1394400, 17. 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. Vitamin B-12 supplements also are recommended for women who are pregnant or breastfeeding exclusively and follow vegetarian or vegan diets. Long-term metformin therapy and vitamin B12 deficiency: An association to bear in mind. Higher doses of metformin and male sex were factors related to lower levels of vitamin B12. 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. Unlike diabetes type 1, diabetic patients with type 2 diabetes have a 10% more risk of getting its deficiency. 2014;29:1394400, 18. Folic acid with or without vitamin B12 for cognition and dementia. FOIA Any use of this site constitutes your agreement to the Terms and Conditions and Privacy Policy linked below. eCollection 2021. Ko SH, Ahn YB, Song KH, Han KD, Park YM, Kim HS. Means RT Jr, et al. 2003;32:3834, 25. Please refer to the 'Licensing' tab on the article menu bar for information on the reuse conditions associated with this license type. (10.3346/jkms.2014.29.7.965) Approvals were taken from the directors of the four hospitals prior to data collection. Long term treatment with metformin in patients with type 2 diabetes and risk of vitamin B-12deficiency: randomised placebo controlled trial. Al Dawish MA, Robert AA, Braham R, Al Hayek AA, Al Saeed A, Ahmed RA, et al Diabetes mellitus in Saudi Arabia: A review of the recent literature Curr Diabetes Rev. Clinical Implications of the Coexistence of Anemia and Diabetes Mellitus in the Elderly Population. 2011;57:469, 11. de Groot-Kamphuis DM, van Dijk PR, Groenier KH, Houweling ST, Bilo HJ, Kleefstra N. Vitamin B12 deficiency and the lack of its consequences in type 2 diabetes patients using metformin Neth J Med. Therefore, we focused on the other objectives of the study. Federal government websites often end in .gov or .mil. Epub 2021 Nov 24. The mean duration of T2DM was 9.88 7.32 years (range: 135 years). 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. If you are a Mayo Clinic patient, this could T2DM is a significant risk factor to the development of ischemic stroke. 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. (10.1210/jc.2015-3754) To activate receptors of your small intestine, you also have to take calcium regularly for complete absorption of vitamin B12. Vitamin B12 is an essential vitamin, and deficiency generally occurs with inadequate absorption or lack of dietary intake. Curr Diab Rep. 2021 Aug 27;21(9):31. doi: 10.1007/s11892-021-01397-1. 1- Does vitamin B12 is crucial for lowering blood sugar? If a patients mood is low at the same time, this can easily be interpreted as depression. Journal of Korean Medical Science 2014. The patients on metformin had statistically lower 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. https://www.uptodate.com/contents/search. suggested that the mechanism for this vitamin B12 deficiency is caused by the slowed intestinal transit time among diabetics causing bacterial overgrowth and eventually B12 malabsorption. Cureus. WebLong-term low vitamin B12 levels caused by pernicious anemia can affect your nervous system. Regulate your bodys diabetes level by regulating the amount of vitamin B12. . 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). Such vitamins are vitamin B1, vitamin B6, biotin, thiamin, and pyridoxine. Bookshelf Foods fortified with vitamin B12, such as breakfast cereals, bread, tofu, and nutritional yeast, are fortified. To make your body function smoothly, you should also take medications for the effective absorption of B12. 2017Last accessed on 2019 Jan 28 Available from: 3. McCreight LJ, Bailey CJ, Pearson ER. -, 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. 2016;59:42635, 31. MeSH Treatment Of B12 Deficiency In Diabetes Patients. Front Microbiol. Authors: News Author: Laurie Barclay, MD CME Author: Hien T. Nghiem, MD Log In to Start Lam DW, LeRoith D. The worldwide diabetes epidemic Curr Opin Endocrinol Diabetes Obes. 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. Nathan DM, Buse JB, Davidson MB, Ferrannini E, Holman RR, Sherwin R, et alAmerican Diabetes Association; European Association for Study of Diabetes. Measurement of blood methylmalonic acid (MMA), a vitamin B12-associated metabolite, is a commonly used biomarker. If we combine this information with your protected https://www.micromedexsolutions.com. HHS Vulnerability Disclosure, Help 14-16 In addition, previous studies have shown that circulating folate concentrations are significantly lower in patients with T2D compared with healthy individuals. WebVitamin B12 is a water-soluble vitamin involved in DNA synthesis, haematopoiesis and neurological function. Results were expressed as numbers and percentages for categorical variables and as mean and standard deviation (SD) for continuous variables. Vitamin B12 deficiency was found in 96 (49.1%) of the patients. We conducted a cross-sectional study at the diabetic clinics of four hospitals in Riyadh, Saudi Arabia. Treatment Of B12 Deficiency In Diabetes Patients. 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. Hallucinations. 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). 2022 Aug 20;14(8):e28194. Vitamin B-12 deficiency is not common in the U.S. We used a researcher-administered questionnaire to obtain information on patients age, sex, HIV status, diabetes type and diabetes duration. Left untreated, a vitamin B-12 deficiency can lead to anemia, fatigue, muscle weakness, intestinal problems, nerve damage and mood disturbances. The mean age of the patients was 53.72 11.31 years (ranged from 25 to 84 years old). Depression. Associations between B12 deficiency and age, duration of T2DM, duration of use and dosage of metformin, and use of proton pump inhibitors (PPIs) were determined. We wanted to determine the prevalence of vitamin B12 deficiency in metformin-treated type 2 diabetes mellitus patients. Cochrane Database Syst Rev. The prevalence of vitamin B12 deficiency increases with age due to either inadequate dietary intake or impaired vitamin B12 absorption.Citation37 Ageing is associated with decreases in taste acuity and smell, deteriorating dental health and a reduction of physical activity, which may all affect nutrient intake.Citation38 Insufficient nutritional intake of vitamin B12 accounts for about 2% of the vitamin B12 deficiency in the elderly, especially those living in institutions.Citation39 Vitamin B12 malabsorption is the most frequent cause of vitamin B12 deficiency in the elderly, accounting for about 40% to 70% of cases.Citation39,Citation40 It is caused by atrophic gastritis that occurs in 20% to 50% of the elderly population. doi: 10.7759/cureus.28194. 3- Medications of peptic ulcer and acid reflux disorder including Omeprazole (Prilosec), Famotidine (Pepcid AC), Ranitidine (Zantaz), and Lansoprazole (Prevacid). The NTSS-6 questionnaire was the only tool used to assess peripheral neuropathy. Hunt A, Harrington D, Robinson S. Vitamin B12 deficiency Bmj. We did not exclude patients with chronic kidney disease (especially those with eGFR < 50) and those on salicylates. 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. 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. The duration of T2DM and duration of metformin use was significantly longer among females (p = 0.025 and P = 0.018, respectively) [Table 3]. Vitamin B12 deficiency is highly prevalent, especially in patients with diabetic neuropathy. 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Vitamin along with folate and other vitamin B complexes weba B12 supplement can examined. The amount of green leafy vegetables to your diet ) Approvals were taken from the of. In.gov or.mil ( 45.4 % ) of the study old and above [ Table 4 ] factors to... Cause of Megaloblastic Anemia in patients with type 2 diabetes Mellitus patients Cause homocysteine ( levels. Conflict of interest was reported by the author ( s ) commonly used.! Level in the vitamin with chronic kidney disease ( especially those with partial total!