scholarly journals Investigation of the vitamin b12 deficiency with peripheral neuropathy in the type 2 diabetes mellitus using metformin

Author(s):  
Serdar Olt
PLoS ONE ◽  
2018 ◽  
Vol 13 (10) ◽  
pp. e0204420 ◽  
Author(s):  
Turki J. Alharbi ◽  
Ayla M. Tourkmani ◽  
Osama Abdelhay ◽  
Hesham I. Alkhashan ◽  
Abdulrahman K. Al-Asmari ◽  
...  

2017 ◽  
Vol 2017 ◽  
pp. 1-6 ◽  
Author(s):  
Marwan A. Ahmed ◽  
George L. Muntingh ◽  
Paul Rheeder

Peripheral neuropathy (PN) is a primary complication of type 2 diabetes mellitus (T2DM) and a direct manifestation of vitamin B12 deficiency. Examining the effects of metformin use on PN status became imperative following clinical studies that showed the vitamin B12-lowering effect of the medication. The complexity of the topic and the inconsistency of the results warrant consideration of topic-specific perspectives for better understanding of the available evidence and more appropriate design of future studies.


Author(s):  
Gomathi A. ◽  
Keerthiga K.

Background: The objective of the study was to estimate the prevalence of vitamin B12 deficiency and presence of peripheral neuropathy in type 2 diabetes patients on metformin treatment.Methods: This cross-sectional study was carried out in Department of Biochemistry and Medicine in a tertiary care teaching hospital in south India. Type 2 diabetes mellitus patients diagnosed based on World Health Organization (WHO) criteria treated with metformin for more than 6 months were included in the study. B12 levels were estimated and DNS scoring, vibration perception test and 10 gm Semmes-Weinstein monofilament test done.Results: A total of 55 participants were identified. Most of them were on 1500 mg of metformin once a day in divided dose. In this study maximum number of participants are in the age group of 50-70 years. Peripheral neuropathy is seen in 43.9% of persons with normal B12 levels and 28.5% of persons with low B12 levels. A Chi square test showed a chi square statistic value of 1.8221 with a p value of 0.312 which is not significant. Univariate analysis showed vitamin B12 deficient patients are of significantly higher age (63 years versus 57 years p=0.01) and with higher duration of treatment (9 years versus 6 years p=0.01).Conclusions: Prolonged metformin therapy is associated with deficiency of vitamin B12. The prevalence of B12 deficiency among diabetic patients on metformin was found to be 25.45%. Routine B12 estimation and correction of low B12 levels will be beneficial to these patients. Earlier initiation of B12 in patients on metformin may prevent the onset of neurological damage.


Diabetes ◽  
2019 ◽  
Vol 68 (Supplement 1) ◽  
pp. 576-P
Author(s):  
VEERAPPA KOTHIWALE ◽  
NAHUSH D. CHAFEKAR ◽  
PRAKASH BABALICHE ◽  
NIKHIL A. CHOUGULE

2017 ◽  
Vol 30 (10) ◽  
pp. 719
Author(s):  
Carlos Tavares Bello ◽  
Ricardo Miguel Capitão ◽  
João Sequeira Duarte ◽  
Jorge Azinheira ◽  
Carlos Vasconcelos

Introduction: Type 2 diabetes mellitus is a common disease, affecting up to 13.1% of the Portuguese population. In addition to the known micro and macrovascular complications, drug side effects constitute a major concern, leading to changes in the treatment guidelines, which favor safety over efficacy. Metformin is the first-line pharmacological treatment for most patients with type 2 diabetes mellitus; however, it has been associated with vitamin B12 deficiency in up to 30% of treated patients. The authors describe the prevalence of vitamin B12 deficiency in a diabetic population and explore the possible underlying factors.Material and Methods: Retrospective, observational study. Clinical and laboratory data of type 2 diabetes mellitus patients whose vitamin B12 status was evaluated in the last decade (2005 - 2016) were analyzed. Patients with known malabsorptive syndromes or having undergone bariatric surgery were excluded from the study. Statistical analysis of the data was done and the results were considered statistically significant at p values < 0.05.Results: The study included a total of 1007 patients (58% women) with a mean age of 66.4 ± 12.2 years and 11 ± 10.4 years of type 2 diabetes mellitus duration. These patients had a high prevalence of complications: diabetic renal disease 47.7%, neuropathy 9.2%, retinopathy 14.9%, coronary artery disease 8.4%, cerebrovascular disease 10.9%, and peripheral arterial disease 5.5%. Vitamin B12 deficiency (< 174 ng / dL) was present in 21.4% of the population and this subgroup was older (68.4 vs 65.8 years, p = 0.006), had a longer type 2 diabetes mellitus duration (13.35 vs 10.36 years; p = 0.001), higher prevalence of retinopathy (20.9% vs 13.3%; p = 0.005) and thyroid dysfunction (34% vs 23.7%; p = 0.002). Vitamin B12 deficiency was also more frequent in patients treated with metformin (24.7% vs 15.8%; p = 0.017), antiplatelet agents (25.4% vs 16.2%, p < 0.001), and calcium channel blockers (26.8% vs 18.2%; p = 0.001). After adjustment for possible confounders, the variables associated with B12 deficiency were: metformin, hypothyroidism, age and type 2 diabetes mellitus duration.Discussion: Despite the retrospective design, the results report a high prevalence of vitamin B12 deficiency in the type 2 diabetic population. This study also demonstrates that the B12 deficiency risk is higher in older people, with longer diabetes mellitus duration, hypothyroidism and treated with metformin.Conclusion: Further studies are needed to identify the risk factors for the B12 deficit. The recognition of these variables will contribute to optimize the screening and prevention of the B12 deficiency in type 2 diabetes mellitus.


2019 ◽  
Vol 13 (1) ◽  
pp. 14-19
Author(s):  
Viswa Viswa S ◽  
Sivasakthi Sivasakthi K ◽  
Monitta Robinson D ◽  
Hariharan Hariharan V

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