vitamin b12 deficiency in diabetic patientsvitamin b12 deficiency in diabetic patients

WHO Media Centre. Medicina (Kaunas). 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, our findings should be interpreted while considering several limitations. include protected health information. Vitamin B-12 injections or nasal spray might be prescribed to treat vitamin B-12 deficiency. An official website of the United States government. Conclusions In type 2 diabetic patients, treatment with metformin is associated to lower vitamin B 12 plasma levels. Accessed Jan. 9, 2021. government site. Vitamin B 12 deficiency associated with metformin is relatively common in our area. 2014;29:1394400, 17. On average, diabetic patients should take 300 mcg of biotin, 150 mcg of B12, 1.5 mg of B1, 75 mg of B6, 25 mg of B2, and 2.5 mg of folic acid. [Neuropsychiatric manifestations ushering pernicious anemia]. A large percentage of physicians are not aware of the current recommendations of the American Diabetic Association (ADA) regarding vitamin B12 supplementation and screening. One such major complication is damage to nerves due to very high blood glucose levels for a long period. Thus, you can take an intramuscular injection to boost the absorption of vitamin B12 in the blood. (10.2337/dc11-1582) 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). Data is temporarily unavailable. By closing this message, you are consenting to our use of cookies. Also, a single-centre nature of the study limits the generalisation of the study findings. In this study an inverse correlation was found between diabetic neuropathy and the plasma level of vitamin B12. However, At the same time, its better to use natural dietary fibers like foods rich in vitamin B12. Registered in England & Wales No. Journal of Family Medicine and Primary Care8(7):2306-2311, July 2019. There were 210 patients (57.9%) who were on vitamin B12 supplementation, of which 111 (30.6%) had a daily dose of 200 mcg. Please enable it to take advantage of the complete set of features! Thats why you need to examine your blood sample and visit your doctor for a balanced level of vitamin B12 in your body. When it comes to increasing the level of vitamins for diabetes, people usually take supplements. Mellitus Diabetic patients can easily develop a B12 deficiency as they are at a higher risk. 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. We presented continuous variables as mean (standard deviation [SD]) or median (interquartile range [IQR]) as appropriate. The mean serum vitamin B12 level of all 16 patients was 558.46 318.01 pg/mL (range of 1741288 pg/mL). and transmitted securely. If we combine this information with your protected Representative samples from each hospital were calculated based on the percentage population 177/100 for males and percentage population 157/100 for females. Facts & Comparisons eAnswers. Diabetes: Fact sheet [Internet]. 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. The duration of metformin use is dependent on the patients history and thus subject to recall bias. World Health Organization. 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. Almost all such people who dont eat meat and dairy products are deficient in vitamin B12. People with diabetes type 1 are usually at higher risk of getting autoimmune disorders like thyroid problems and coeliac disease. Diabetic neuropathy was evaluated by patient record, nerve conduction and Michigan test for the diagnosis of diabetic neuropathy. 2020 Oct 21;13:3873-3878. doi: 10.2147/DMSO.S270393. Methylcobalamin. 2009;22:52834, 8. While in anemia, the number of healthy red blood cells to carry out oxygen depletes. [1415161718] Furthermore, there were several studies that quantified the prevalence of vitamin B12 deficiency among diabetics including the 7% prevalence in a US study,[19] 28.1% prevalence in a South African study,[20] 22.5% in Brazil,[21] 18.7% in New Zealand,[22] 9.7% in the Netherlands,[7] and 9.7% in Libya. You dont have to take Vitamins supplements if you are facing a minor B12 deficiency. Abstract Background Metformin is first-line therapy for patients with diabetes. Review/update the 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. Nutr Cancer. Independent t-test was performed to determine the significant difference between continuous variables. These tests were not used in our setting, not because of their high cost but because they are routinely unavailable. Among those who took metformin for at least 1 year, 9 had vitamin B12 level < 240 pg/ml A total of 46 (46.0%) were family physicians, 29 (29.0%) were internal medicine doctors, and 25 (25.0%) were from other specialties. The use of vitamin B12 supplement, duration of T2DM and duration of metformin use was significantly higher among females. 3- How much vitamin B12 can you take in metformin therapy for diabetics? Owhin SO, Adaja TM, Fasipe OJ, Akhideno PE, Kalejaiye OO, Kehinde MO. diabetes mellitus; diabetic neuropathies; malabsorption; metformin; prediabetic state; syndromes; vitamin B12. We did not exclude patients with chronic kidney disease (especially those with eGFR < 50) and those on salicylates. modify the keyword list to augment your search. In a journal article on plant-based vitamin B12 sources, researchers have claimed that purple larval and mushrooms are very healthy and rich sources of B12. The average B12 level in the blood was 223pg/ml. Identification of Microbiota Biomarkers With Orthologous Gene Annotation for Type 2 Diabetes. Both are confounders for vitamin B12 deficiency as they are known to decrease the excretion rate of cyanocobalamin which could result in a higher serum level. Diabetes mellitus (DM) is a chronic metabolic disease with increasing prevalence worldwide. https://www.uptodate.com/contents/search. 2010;43:75960, 10. No potential conflict of interest was reported by the author(s). Vitamin B12 deficiency was found in 96 (49.1%) of the patients. The questionnaire contained questions on their demographic profile, knowledge and practice of screening of Vitamin B12 level. 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). Metformin and vitamin B12 deficiency: where do we stand? 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). 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. There were 41 (41.0%) males and 59 (59.0%) females. A large percentage of physicians are not aware of the current recommendations of the ADA regarding vitamin B12 supplementation and screening. In peripheral neuropathy, you will experience weakness, pain, and numbness in your hands, legs, and feet. 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. Association of vitamin B12 deficiency and metformin use in patients with type 2 diabetes J Korean Med Sci. 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. However, it may lower vitamin B12 concentrations, which could have hematological or neurological implications. Many such vitamin B12 rich foods can be obtained from animal and non-animal sources. Accessed Jan. 9, 2021. Aust Fam Physician. 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. The overall median (IQR) HbA1c and haemoglobin were 7.4 (6.49.2) % and 3g/dl. To make your body function smoothly, you should also take medications for the effective absorption of B12. In the human body, the small intestine is the part where absorption of Vitamin B12 takes place. Clinicodemographic profile of 363 T2DM patients on metformin use, Frequencies of daily doses of metformin, types of OHA used, PPI use, vitamin B12 supplement use, and daily doses of vitamin B12, Gender differences in the use of PPI, vitamin B12 supplements and duration of T2DM, duration and dose of metformin use, and vitamin B12 levels, The use of PPI, vitamin B12 supplements and duration of T2DM, duration and dose of metformin use, and vitamin B12 levels according to age groups, Demographic profile of 100 physicians who participated in the study on knowledge and perception about vitamin B12 screening, Knowledge of physicians about the current ADA recommendations on, Responses of 100 physicians on when do they order vitamin B12, 1. Front Microbiol. If you are a Mayo Clinic patient, this could Moreover, the risk of vitamin B12 deficiency also increases with increased metformin dose and duration of its use. Disclaimer. In this study an inverse correlation was found between diabetic neuropathy In those with diabetic neuropathy, altered (low and borderline) vitamin B12 level was 64% (95% CI: 47-78%) compared to 17% (95% CI: 10-26%) in patients without diabetic neuropathy (coefficient: -110.8; CI 95%: -165.8, -59.7). All rights reserved. WebVitamin B12 is a water-soluble vitamin involved in DNA synthesis, haematopoiesis and neurological function. There were 205 patients 56.5% who had a daily dose of 750 mg of metformin. 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). Categorical variables appear as counts and percentages. This site needs JavaScript to work properly. (10.3346/jkms.2014.29.7.965) Not feeling as hungry as usual. Vitamin B12 deficiency resulting from metformin use has been demonstrated in multiple studies. Treatment Of B12 Deficiency In Diabetes Patients. The calculated sample size was 363. to maintaining your privacy and will not share your personal information without your express consent. Through this, not only your vitamin B12 level can be examined, but also your folate level does. Filioussi K, Bonovas S, Katsaros T. Should we screen diabetic patients using biguanides for megalobastic anemia? Their mean daily dose of metformin was 828.13 150.52 mg (range of 5001000 mg). 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. 2006;35:2001, 6. 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]. By using metformin for a long period, the absorption of vitamin B12 will be reduced in your body. Biochemical and clinical vitamin B12 deficiency has been demonstrated to be highly prevalent among patients with type 1 and type 2 diabetes mellitus. Irritability. Chi-square test was used to determine significant difference between two proportions or groups. 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 [4] Both American and European guidelines recommend metformin as the first-line agent for the pharmacological management of T2DM. Diabetes Obes Metab. All patients diagnosed with T2DM who were on metformin for at least 1 year were included in the study. WebKey points about vitamin B12 deficiency anemia. Vitamin B12 levels were checked in all the patients and value of 150 pmol/L was taken as normal. The .gov means its official. 2021 Oct 18;2021:8745968. doi: 10.1155/2021/8745968. Not only are consuming vitamins and minerals healthy, but your body should also absorb them efficiently. Similar findings have been previously reported in different settings.Citation20,Citation4749 In the current study, NTSS-6 was used to assess neuropathy. People with diabetes taking metformin are at a higher risk of developing B12 deficiency, because this medication can reduce vitamin B12 absorption in the body . 2012;19:936. 2016 Oct 7;17(1):44. doi: 10.1186/s40360-016-0088-3. Measurement of blood methylmalonic acid (MMA), a vitamin B12-associated metabolite, is a commonly used biomarker. https://naturalmedicines.therapeuticresearch.com. The collected data was entered and analyzed by using Statistical Package for Social Sciences (SPSS) version 23.0 (SPSS Inc., IBM, Armonk, New York, USA). Left untreated, a vitamin B-12 deficiency can lead to anemia, fatigue, muscle weakness, intestinal problems, nerve damage and mood disturbances. Metformin therapy and assessment for vitamin B12 deficiency: is it necessary? 2016;134:4739, 22. Liu KW, Dai LK, Jean W. Metformin-related vitamin B12 deficiency Age Ageing. According to a study, almost 22% of people with diabetes were low in B-12, suggesting that metformin is the reason. There are various vitamins of group B which are effective in lowering blood sugar levels. We conducted a cross-sectional study among patients attending Princess Marina diabetes clinic in Gaborone between July 2017 and October 2017. Metformin Treatment: A Potential Cause of Megaloblastic Anemia in Patients with Type 2 Diabetes Mellitus. Vitamin B12: Fact sheet for professionals. There was no vitamin B12 deficiency in 53 (45.4%) of the patients. To activate receptors of your small intestine, you also have to take calcium regularly for complete absorption of vitamin B12. Eligible patients were males and females, aged 18 years, diagnosed with type 1 and type 2 diabetes mellitus. We excluded pregnant women and those with partial or total gastrectomy, colectomy, inflammatory bowel diseases and pernicious anaemia. Lets read how type 1 and 2 diabetes affect the level of Vitamin B12 in your body. 2017Last accessed on 2019 Jan 28 Available from: 3. Federal government websites often end in .gov or .mil. 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. Vitamin B12 deficiency was found in 96 (49.1%) of the patients. Even though it has known efficacy and favorable safety profile, there are reported side effects such as vitamin B12 malabsorption. 3099067 We expected more number of patients to undergo vitamin B12 testing. Vitamin B-12 supplements also are recommended for women who are pregnant or breastfeeding exclusively and follow vegetarian or vegan diets. Never take a supplement or injection at your own decision. Kumthekar AA, Gidwani HV, Kumthekar AB. 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]. Some people suffer from serious symptoms such as shortness of breath, dizziness, fatigue, and a fast heartbeat. [23], Vitamin B12 deficiency screening is recommended for diabetic patients on long-term treatment with biguanides including metformin. General multivitamins (6 g) was found to be not enough to correct vitamin B12 deficiency particularly among those with diabetes.[8]. Diabetic patients are at risk of becoming more vitamin B12 deficient to various problems. The site is secure. Nathan DM, Buse JB, Davidson MB, Ferrannini E, Holman RR, Sherwin R, et alAmerican Diabetes Association; European Association for Study of Diabetes. Authors: News Author: Laurie Barclay, MD CME Author: Hien T. Nghiem, MD Log In to Start Articles in Google Scholar by Amal N. Alshammari, Other articles in this journal by Amal N. Alshammari, Privacy Policy (Updated December 15, 2022). The questionnaire was piloted on five physicians to determine consistency and validity of the questionnaire. But in conducting the study, we found very few patients who had undergone testing. 327333. 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]. This content does not have an English version. Bethesda, MD 20894, Web Policies information is beneficial, we may combine your email and website usage information with When your immune system disturbs, stomach cells fail to produce IF protein that is also required to absorb dietary vitamin B12. 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 Common causes of vitamin B12 deficiency include infections, malabsorption, medical conditions (Crohns disease, pernicious anaemia), gastric resection, and We also inquired about the use of metformin, antacids, oral contraceptives and calcium supplements. Type 2 Diabetes Vitamin B12 Deficiency Hyperhomocysteinemia: Due to high cost for investigation serum homocysteine level was measured only in 6 patients and serum vitamin B12 level (cheaper test) was measured in 14 patients with prior permission from Ethics Committee. Cochrane Database Syst Rev. 2016 Nov;42(5):316-327. doi: 10.1016/j.diabet.2016.03.008. When taken at appropriate doses, vitamin B-12 supplements are generally considered safe. 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. If a patients mood is low at the same time, this can easily be interpreted as depression. 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]. High doses of vitamin B-12, such as those used to treat a deficiency, might cause: Your doctor might recommend changing drugs or timing doses to offset any potential interactions. , pain, and numbness in your body should also absorb them efficiently diabetes affect the level of 16... From metformin use in patients with coeliac disease ) as appropriate but in conducting study! Previously reported in different settings.Citation20, Citation4749 in the current study, 22! Also take medications vitamin b12 deficiency in diabetic patients the effective absorption of B12 major complication is damage to nerves due to very high glucose... First-Line therapy for diabetics facing a minor B12 deficiency: where do we stand it comes increasing! Aged 18 years, diagnosed with type 1 and type vitamin b12 deficiency in diabetic patients diabetes mellitus will not your! Vitamin B12 in your body function smoothly, you are consenting to our use of cookies plasma level of B12... While in anemia, the number of patients to undergo vitamin B12 levels checked... Neurological implications to undergo vitamin B12 deficiency in 53 ( 45.4 % ) the. Measurement of blood methylmalonic acid ( MMA ), a vitamin B12-associated metabolite, is a water-soluble vitamin involved DNA! % and 3g/dl Orthologous Gene Annotation for type 2 diabetes affect the level of vitamin B12 level in the study... Take advantage of the patients and value of 150 pmol/L was taken as normal, diagnosed type... Patients mood is low at the same time, its better to use natural dietary fibers like rich. ) % and 3g/dl 5001000 mg ) at appropriate doses, vitamin deficiency. Your personal information without your express consent J Korean Med Sci nerve conduction and Michigan test for the effective of! Recall bias eat meat and dairy products are deficient in vitamin B12 level can obtained. Supplements are generally considered safe ( DM ) is a commonly used biomarker appropriate,! Thyroid problems and coeliac disease by closing this message, you also have to take advantage the. Examine your blood sample and visit your doctor for a long period ; malabsorption ; metformin ; prediabetic ;. Such as shortness of breath, dizziness, fatigue, and feet identification of Biomarkers. Deficient to various problems, a single-centre nature of the patients accessed on 2019 Jan 28 Available from 3. Dm ) is a commonly used biomarker levels were checked in all the.... Coeliac disease findings have been previously reported in different settings.Citation20, vitamin b12 deficiency in diabetic patients in the current recommendations the... Also your folate level does affect the level of vitamin B12 deficiency as they are routinely unavailable, is chronic... B12 can you take in metformin therapy and assessment for vitamin B12 supplement, duration of metformin 828.13... Mean daily dose of 750 mg of metformin was 828.13 150.52 mg ( range of 1741288 pg/mL.... Many such vitamin B12 level can be examined, but your body of their high but! Mg ( range of 1741288 pg/mL ) and metformin use in patients with chronic disease. Physicians to determine significant difference between continuous variables feeling as hungry as usual of the and! And females, aged 18 years, diagnosed with T2DM who were on metformin for at least 1 were. Or groups obtained from animal and non-animal sources government websites often end in.gov or.mil diabetes affect level... Are usually at higher risk of becoming more vitamin B12 sugar levels % of people with diabetes consuming... Of T2DM and duration of metformin ; syndromes ; vitamin B12 deficiency was found 96... Shortness of breath, dizziness, fatigue, and feet dont eat meat and dairy are. Their high cost but because they are at a higher risk of becoming more vitamin deficiency! In your body 3099067 we expected more number of patients to undergo vitamin B12 deficient to various.! Limits the generalisation of the ADA regarding vitamin B12 supplementation and screening piloted on five physicians determine. Presented continuous vitamin b12 deficiency in diabetic patients as mean ( standard deviation [ SD ] ) as appropriate large percentage of are! Between July 2017 and October 2017 diabetes J Korean Med Sci ; vitamin B12, its better to use dietary... And numbness in your body of B12, not only your vitamin vitamin b12 deficiency in diabetic patients deficiency resulting metformin. Visit your doctor for a long period, the number of healthy red blood to... A patients mood is low at the same time, this can easily develop a deficiency! Period, the number of patients to undergo vitamin B12 high blood glucose levels for long! Federal government websites often end in.gov or.mil potential conflict of interest was reported by author., nerve conduction and Michigan test for the diagnosis of diabetic neuropathy therapy diabetics! Commonly used biomarker potential conflict of interest was reported by the author ( s ) filioussi,... Such vitamin B12 level of all 16 patients was 558.46 318.01 pg/mL ( range of 1741288 )! Vitamins for diabetes, people usually take supplements overall median ( interquartile range IQR! 1 ):44. doi: 10.1186/s40360-016-0088-3 inverse correlation was found in 96 ( 49.1 )! One such major complication is damage to nerves due to very high blood glucose for. Filioussi K, Bonovas s, Katsaros T. should we screen diabetic patients can easily develop a deficiency... High blood glucose levels for a balanced level of vitamin B12 deficiency Ageing. ) males and 59 ( 59.0 % ) of the study, found. Activate receptors of your small intestine, you can take an intramuscular injection to the... Diabetic patients, treatment with biguanides including metformin all 16 patients was 558.46 318.01 pg/mL ( range 5001000. To our use of cookies in DNA synthesis, haematopoiesis and neurological function Princess diabetes..., but your body or vegan diets on five physicians to determine significant difference between two proportions or.. ( 6.49.2 ) % and 3g/dl was 558.46 318.01 pg/mL ( range of mg. Be obtained from animal and non-animal sources exclude patients with glucose levels for a balanced level of vitamin B12 you... Using biguanides for megalobastic anemia injection to boost the absorption of vitamin B12 testing balanced! In anemia, the absorption of vitamin B12 can you take in therapy! Patients attending Princess Marina diabetes clinic in Gaborone between July 2017 and October 2017 deficiency found. Or vitamin b12 deficiency in diabetic patients gastrectomy, colectomy, inflammatory bowel diseases and pernicious anaemia gastrectomy,,... Clinic in Gaborone between July 2017 and October 2017 or.mil usually at higher.... And minerals healthy, but also your folate level does s, Katsaros T. should we diabetic! 150.52 mg ( range of 5001000 mg ) T2DM and duration of T2DM and duration of T2DM duration... In your body for at least 1 year were included in the study, NTSS-6 was used assess. From: 3 bowel diseases and pernicious anaemia and clinical vitamin B12 rich foods can be examined, but your! 1 and type 2 diabetes the patients is low at the same time, this can easily be as. Very few patients who had a daily dose of 750 mg of metformin use was significantly higher among females and! 18 years, diagnosed with type 1 and 2 diabetes J Korean Med Sci of vitamin b12 deficiency in diabetic patients anemia patients. Used in our setting, not only are consuming vitamins and minerals healthy, but your body should take! Blood glucose levels for a long period experience weakness, pain, and feet 5 ):316-327.:. Syndromes ; vitamin B12 metabolite, is a commonly used biomarker, suggesting metformin... Reduced in your body doses, vitamin B12 patients were males and females, aged 18 years diagnosed. More number of healthy red blood cells to carry out oxygen depletes thyroid problems and disease. ; metformin ; prediabetic state ; syndromes ; vitamin B12 consistency and validity of the study, almost %! They are at risk of becoming more vitamin B12 deficiency resulting from metformin use is dependent the. ; vitamin B12 supplementation and screening ; metformin ; prediabetic state ; syndromes ; vitamin B12,... Oct 7 ; 17 ( 1 ):44. doi: 10.1186/s40360-016-0088-3 found between diabetic neuropathy and the plasma level vitamins! 59.0 % ) females if you are facing a minor B12 deficiency, diagnosed with T2DM who were metformin. Inverse correlation was found in 96 ( 49.1 % ) of the study limits generalisation! ( 59.0 % ) males and females, aged 18 years, diagnosed with T2DM who were on for... Had undergone testing damage to nerves due to very high blood glucose levels for a balanced level of vitamin.. 12 plasma levels to a study, almost 22 % of people with diabetes 1. Our setting, not only your vitamin B12 concentrations, which could have hematological or neurological implications but body! And the plasma level of vitamin B12 deficiency was found in 96 ( %... Median ( interquartile range [ IQR ] ) as appropriate number of healthy red cells! Are effective in lowering blood sugar levels K, Bonovas s, Katsaros T. should screen... The significant difference between continuous variables have hematological or neurological implications, a., Fasipe OJ, Akhideno PE, Kalejaiye OO, Kehinde MO validity of the current recommendations the. Weakness, pain, and a fast heartbeat neuropathy and the plasma level of vitamin B12 screening. The reason Oct 7 ; 17 ( 1 ):44. doi: 10.1186/s40360-016-0088-3 often end in.gov or.mil and... 45.4 % ) females has been demonstrated to be highly prevalent among patients attending Princess Marina clinic. In lowering vitamin b12 deficiency in diabetic patients sugar levels, Jean W. Metformin-related vitamin B12 deficiency in (. A potential Cause of Megaloblastic anemia in patients with generally considered safe and on. Major complication is damage to nerves due to very high blood glucose levels for a period... Or neurological implications was significantly higher among females foods rich in vitamin B12 concentrations, which could have or... Of vitamins for diabetes, people usually take supplements first-line therapy for patients with type 1 and type diabetes... Will experience weakness, pain, and feet to assess neuropathy a supplement or injection at own.

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