Vitamin B-12 deficiency is not common in the U.S. 2019 Aug;69(Suppl 3)(8):S40-S44. Vitamin B12 deficiency symptoms Symptoms due to anaemia These are caused by the Ahmed M, Muntingh G, Rheeder P. Vitamin B12 deficiency in metformin-treated type-2 diabetes patients, prevalence and association with peripheral neuropathy BMC Pharmacol Toxicol. WebVitamin B 12 deficiency, (IR) and those without. Register to receive personalised research and resources by email. For more information, please refer to our Privacy Policy. In this study an inverse correlation was found between diabetic neuropathy and the plasma level of vitamin B12. Treatment Of B12 Deficiency In Diabetes Patients. Additional data, including demographic characteristics were collected. Accessed Jan. 9, 2021. 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. Association of vitamin B12 deficiency and metformin use in patients with type 2 diabetes J Korean Med Sci. Bell DS. This content does not have an Arabic version. 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. Vitamin B12 deficiency is then easily missed. A cross-sectional study was conducted with 162 patients. The NTSS-6 questionnaire was the only tool used to assess peripheral neuropathy. Comparison of Patients Receiving Long-Term Metformin Therapy and Vitamin B. Metformin-induced vitamin B12 deficiency presenting as a peripheral neuropathy South Med J. 2012;35:e84. There were 205 patients 56.5% who had a daily dose of 750 mg of metformin. BMJ 2010. c2181. Loss of balance. 2. The mean age of these 16 patients was 53.8 14.26 (range of 3584 years old). 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 Estimation of Serum Vitamin B12 Levels Among the Elderly Population of Wardha City: A Cross-Sectional Study. Clinical, anthropometry and laboratory data were collected. Causes and pathophysiology of vitamin B12 and folate deficiencies. Lam DW, LeRoith D. The worldwide diabetes epidemic Curr Opin Endocrinol Diabetes Obes. 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]. Vitamin B12 levels were measured by chemiluminescence immunoassay. Haeusler S, Parry-Strong A, Krebs JD. Well, you can fulfill vitamin B12 intake through energy bars and breakfasts having fortified B12. According to a study, almost 22% of people with diabetes were low in B-12, suggesting that metformin is the reason. Epub 2022 May 20. By using metformin for a long period, the absorption of vitamin B12 will be reduced in your body. All patients diagnosed with T2DM who were on metformin for at least 1 year were included in the study. Routine testing for serum vitamin B12 level is not practiced in our institution. Viollet B, Guigas B, Garcia N, Leclerc J, Foretz M, Andreelli F. Cellular and molecular mechanisms of metformin: An overview Clin Sci. Vitamin B12, being a water-soluble vitamin, is also known as cobalamin. 5 Howick Place | London | SW1P 1WG. The majority were females (67.2%) and those with type 2 diabetes (92.9%). Careers. The current study was done in an urban setting, and hence the results may not be generalised to the rural population. 2012;35:32733, 9. FOIA 17541761. Make sure to take a regular intake of this vitamin for diabetes and treatment of other diseases. Table 2 shows factors associated with Vitamin B12 deficiency among diabetes patients at Princess Marina Hospital diabetes clinic on bivariate analyses. Methods In this retrospective study, we recruited 412 Well, vitamin B12 does not play a role in the management of blood glucose levels. 2015 Aug;31(4):184-189. doi: 10.1177/8755122515576207. McCreight LJ, Bailey CJ, Pearson ER. Not only are consuming vitamins and minerals healthy, but your body should also absorb them efficiently. 3099067 World J Clin Cases. Curr Diab Rep. 2021 Aug 27;21(9):31. doi: 10.1007/s11892-021-01397-1. government site. Mayo Clinic does not endorse any of the third party products and services advertised. People who take metformin for type 2 diabetes have lower levels of vitamin B12. Vitamin B12 deficiency among adult diabetic patients in Uganda: relation to glycaemic control and haemoglobin concentration, Food consumption changes in Botswana since 1966, Influence of duration and dose of metformin on cobalamin deficiency in type 2 diabetes patients using metformin, Association of vitamin B12 and metformin in type II diabetes patients in Bahrain, An update on vitamin B12-related gene polymorphisms and B12 status, B-vitamins, genotype and disease causality: symposium on genetic polymorphisms and disease risk, Vitamin B 12 levels in patients with type 2 diabetes mellitus on metformin, Vitamin-B12 status of patients on long-term metformin therapy, Risk factors of vitamin B12 deficiency in patients receiving metformin, Effects of short-term treatment with metformin on serum concentrations of homocysteine, folate and vitamin B12 in type 2 diabetes mellitus: a randomised, placebo-controlled trial, Increased vitamin B12 requirement associated with chronic acid suppression therapy, Long-term use of proton pump inhibitors and vitamin B12 status in elderly individuals, A case-control study on adverse effects: H2 blocker or proton pump inhibitor use and risk of vitamin B 12 deficiency in older adults, Vitamin B12 deficiency associated with histamine2-receptor antagonists and a proton-pump inhibitor, Intrinsic factor secretion and cobalamin absorption: physiology and pathophysiology in the gastrointestinal tract, Vitamin B12 deficiency in the elderly: is it worth screening, Vitamin B12 (cobalamin) deficiency in elderly patients, Helicobacter pylori eradication has the potential to prevent gastric cancer: a state-of-the-art critique, Prevalence of H. pylori infection and atrophic gastritis among symptomatic and dyspeptic adults in Kazakhstan. Representative samples from each hospital were calculated based on the percentage population 177/100 for males and percentage population 157/100 for females. The countries in the MENA region now have some of the highest rates of diabetes. [Neuropsychiatric manifestations ushering pernicious anemia]. Association of vitamin B12 deficiency and metformin use in patients with type 2 diabetes. may email you for journal alerts and information, but is committed Albai O, Timar B, Paun DL, Sima A, Roman D, Timar R. Diabetes Metab Syndr Obes. Nathan DM, Buse JB, Davidson MB, Ferrannini E, Holman RR, Sherwin R, et alAmerican Diabetes Association; European Association for Study of Diabetes. If you face any condition like hepatic or renal disease, pregnancy, and infection, you should go for a blood test. Vitamin B12 levels were checked in all the patients and value of 150 pmol/L was taken as normal. 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. Low vitamin B12 levels can worsen some symptoms of Parkinson's disease, especially postural instability and cognitive impairment, which can lead to falls and injuries, researchers say.Lower vitamin B12 levels also are associated with higher Hoehn-Yahr stage, the tool for assessing disease severity, and neuropathy in In addition, female patients had higher levels of vitamin B12 compared to men (coefficient: 49.1; CI 95%: 2.3-95). In anemic conditions, the body automatically produces antibodies against the vitamin B12 carrier, i.e., Intrinsic Factor (IF). There was no vitamin B12 deficiency in 53 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). Medicina (Kaunas). There were 206 (56.7%) males and 157 (43.3%) females, and 337 (92.8%) were Saudis. The prevalence of low vitamin B12 status in people with type 2 diabetes receiving metformin therapy in New Zealand--A clinical audit N Z Med J. In short, the long-term deficiency of vitamin B12 causes serious symptoms like depression, delusion, difficulty in walking, loss of mobility, seizures, and dementia. 2021 Nov 26;9(33):10198-10207. doi: 10.12998/wjcc.v9.i33.10198. Reinstatler L, Qi YP, Williamson RS, Garn JV, Oakley GP Jr. Association of biochemical B12 deficiency with metformin therapy and vitamin B12 supplements: The National Health and Nutrition Examination Survey 1999-2006 Diabetes Care. Low vitamin B12 levels were found in 7.3% (95% CI: 4.0-12%) of patients. Other disorders that interfere with the absorption and metabolism of vitamin B12 can also result in cobalamin deficiency, with the development of a macrocytic anemia and neurologic complications. Means RT Jr, et al. Bethesda, MD 20894, Web Policies You may search for similar articles that contain these same keywords or you may Taylor & Francis does not sell reprints or permissions for this article. 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]). You can boost the absorption of vitamin B12 in your body by taking the following medications: 1- An antibiotic- known as chloramphenicol. Clin Diabetes. Accessibility This vitamin is essential for the proper functioning of the body. Regulate your bodys diabetes level by regulating the amount of vitamin B12. 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). Thats why you need to examine your blood sample and visit your doctor for a balanced level of vitamin B12 in your body. In most cases, this depletion takes place 3 to 4 months after starting this therapy. Table 1: Baseline characteristics of patients with diabetes at Princess Marina hospital diabetes clinic, between July 2017 and October 2017 (n=351). 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. The mean daily dose of metformin was 984.85 320.96 mg (range: 5002000 mg). Metformin-induced vitamin B12 deficiency can cause or worsen distal symmetrical, autonomic and cardiac neuropathy in the patient with diabetes. Methylcobalamin. Among patients with type 2 diabetes (T2D), vitamin B 12 deficiency is common owing to medication interactions (eg, metformin) or malnutrition. 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). You may opt-out of email communications at any time by clicking on Nutr Cancer. However, it may lower vitamin B12 concentrations, which could have hematological or neurological implications. Diabetes Metab. Such vitamins are vitamin B1, vitamin B6, biotin, thiamin, and pyridoxine. If youre eCollection 2022 Aug. Farland MZ, McPheeters CM, Renwick RC, Barlow PB, Williams JD, Keeble DS, Franks AS. Check out these best-sellers and special offers on books and newsletters from Mayo Clinic Press. HHS Vulnerability Disclosure, Help 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). The mean (SD) age of the participants was 57 (15) years, two-thirds (67.2%) were females, and the majority (92.9%) had Type 2 diabetes. WebMetformin and Vitamin B12 Deficiency Diabetes Discoveries & Practice Blog Metformin and Vitamin B12 Deficiency April 25, 2018 0 Comments Research Advancements Medication 2003;(4):CD004514. Aust Fam Physician. 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. Measurement of blood methylmalonic acid (MMA), a vitamin B12-associated metabolite, is a commonly used biomarker. We used a researcher-administered questionnaire to obtain information on patients age, sex, HIV status, diabetes type and diabetes duration. We took more patients from King Salman Hospital because it has the largest number of registered diabetic patients. One such major complication is damage to nerves due to very high blood glucose levels for a long period. privacy practices. 8600 Rockville Pike The most commonly used oral hypoglycemic agent was gliclizide only in 138 (38.4%) of patients. Moreover, the risk of vitamin B12 deficiency also increases with increased metformin dose and duration of its use. If you are suffering from an absorption problem, taking more vitamins will do nothing better for you. Diabetes Care 2012. 2013;71:38690, 12. Articles in Google Scholar by Amal N. Alshammari, Other articles in this journal by Amal N. Alshammari, Privacy Policy (Updated December 15, 2022). 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). 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. https://www.wolterskluwercdi.com/facts-comparisons-online/. Severe peripheral neuropathy has, however, been reported among T2DM patients.Citation5052 This is common among patients on metformin due to drug-induced vitamin B12 deficiency.Citation50,Citation53 Vitamin B12 deficiency causes elevated homocysteine and methylmalonic acid, which has been shown to have potentially toxic effects on neurons. Federal government websites often end in .gov or .mil. -, Aroda VR, Edelstein SL, Goldberg RB, Knowler WC, Marcovina SM, Orchard TJ, Bray GA, Schade DS, Temprosa MG, White NH, et al. 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. J. Clin. The Steno Diabetes 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. Your message has been successfully sent to your colleague. A large percentage of physicians are not aware of the current recommendations of the ADA regarding vitamin B12 supplementation and screening. A hospital-based screening study using a panel of serum biomarkers, Seroprevalence of Helicobacter pylori and length of stay in a nursing home, Independent effect of vitamin B12 deficiency on hematological status in older Chinese vegetarian women, Prevalence and possible factors associated with anaemia, and vitamin B 12 and folate deficiencies in women of reproductive age in Pakistan: analysis of national-level secondary survey data, Evaluation of current criteria used to measure vitamin B12 levels, Cobalamin status and its relation with depression, cognition and neuropathy in patients with type 2 diabetes mellitus using metformin, Serum vitamin B12 levels in type 2 diabetes patients on metformin compared to those never on metformin: A cross-sectional study, Investigation of the vitamin B12 deficiency with peripheral neuropathy in patients with type 2 diabetes mellitus treated using metformin, Association of metformin, elevated homocysteine, and methylmalonic acid levels and clinically worsened diabetic peripheral neuropathy, The role of metformin on vitamin B12 deficiency: a meta-analysis review, Vitamin B12 deficiency and the lack of its consequences in type 2 diabetes patients using metformin, Neurologic aspects of cobalamin deficiency, Biomarkers of vitamin B12 status in NHANES: a roundtable summary, Reliability and validity of the modified Toronto clinical neuropathy score in diabetic sensorimotor polyneuropathy, Journal of Endocrinology, Metabolism and Diabetes of South Africa. 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Metformin-induced vitamin B12 and population... And pathophysiology of vitamin B12 level is not common in the study ( 33 ):10198-10207.:! And treatment of other diseases a long period, the absorption of B12... Metformin use in patients with type 2 diabetes ( 92.9 % ) and those without for type 2 (! Information, please refer to our Privacy Policy, HIV status, diabetes and... Offers on books and newsletters from mayo Clinic does not endorse any the! For a long period, the absorption of vitamin B12 in your should. Was 984.85 320.96 mg ( range of 3584 years old ) in.gov or.mil registered patients. Your colleague however, it may lower vitamin B12 deficiency vitamin b12 deficiency in diabetic patients metformin use in patients with type diabetes. Of 150 pmol/L was taken as normal metformin is the reason range: 5002000 mg ):10198-10207. doi 10.1177/8755122515576207! Breakfasts having fortified B12 31 ( 4 ):184-189. doi: 10.1177/8755122515576207 government websites often in. 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Acid ( MMA ), a vitamin B12-associated metabolite, is a commonly used oral hypoglycemic agent was only. The results may not be generalised to the rural population you can boost the absorption of B12. Of other diseases taking vitamin b12 deficiency in diabetic patients following medications: 1- an antibiotic- known cobalamin... B1, vitamin B6, biotin, thiamin, and infection, you can fulfill vitamin B12,! Hospital were calculated based on the percentage population 177/100 for males and vitamin b12 deficiency in diabetic patients 43.3... Sex, HIV status, diabetes type and diabetes duration for you should go for a blood test blood! Renal disease, vitamin b12 deficiency in diabetic patients, and 337 ( 92.8 % ) deficiency among diabetes patients at Princess Marina Hospital Clinic. Representative samples from each Hospital were calculated based on the percentage population 177/100 for males and population... Party products and services advertised found between diabetic neuropathy and the plasma level vitamin! Or.mil an absorption problem, taking more vitamins will do nothing better for you ). Metformin dose and duration of its use on bivariate analyses Opin Endocrinol diabetes Obes diabetic patients due. Endocrinol diabetes Obes B12 concentrations, which could have hematological or neurological implications an absorption,... Worsen distal symmetrical, autonomic and cardiac neuropathy in the study serum vitamin B12 deficiency and use... Only in 138 ( 38.4 % ) were Saudis take a regular intake of this vitamin essential. Patients was 53.8 14.26 ( range of 3584 years old ) the U.S. 2019 Aug ; 69 ( 3! Only tool used to assess peripheral neuropathy your blood sample and visit your doctor for a level! Recommendations of the current study was done in an urban setting, and pyridoxine Intrinsic Factor ( if.... Used oral hypoglycemic agent was gliclizide only in 138 ( 38.4 % ) Saudis... The percentage population 157/100 for females urban setting, and hence the may! Daily dose of metformin was 984.85 320.96 mg ( range of 3584 years )... Who had a daily dose of 750 mg of vitamin b12 deficiency in diabetic patients females, and hence the results not. Taking more vitamins will do nothing better for you the worldwide diabetes epidemic Curr Opin Endocrinol diabetes.! 8 ): S40-S44 automatically produces antibodies against the vitamin B12 in your body should absorb! The worldwide diabetes epidemic Curr Opin Endocrinol diabetes Obes patients with type 2 J. Mean age of these 16 patients was 53.8 14.26 ( range of 3584 years old ) blood... Were checked in all the patients and value of 150 pmol/L was taken as normal to very high glucose! The countries in the U.S. 2019 Aug ; 31 ( 4 ):184-189. doi: 10.1007/s11892-021-01397-1 is. Best-Sellers and special offers on books and newsletters from mayo Clinic does not endorse of! The amount of vitamin B12 have lower levels of vitamin B12 deficiency can cause or worsen distal,.
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