A comparative study of levels of vitamin B12 in patients of type 2 diabetes mellitus on metformin and not on metformin at tertiary care center

Agarwal, Priti; Meena, Vinay Kumar; Mital, Premlata; Nawal, C. L.; Goyal, Laxmi Kant

doi:10.18203/2349-3933.ijam20162531

Cited by 9 publications

(6 citation statements)

References 17 publications

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“…It is similar to a study done by Agarwal P et al, in 2016, where the mean duration of T2DM was around 6.15 y [13].…”

Section: Discussionsupporting

confidence: 90%

Comparative Study of Vitamin B12 Deficiency Associated With Metformin and Metformin in Combination With DPP-4 Inhibitors in a Tertiary Care Hospital

MISBAH,

SIDDIQUA,

MASOOD

et al. 2023

Int J Pharm Pharm Sci

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Objective: To estimate the prevalence of vitamin B12 deficiency in type 2 diabetes mellitus patients receiving metformin and metformin in combination with DPP-4 inhibitors. To evaluate the vitamin B12 levels induced by long-term metformin usage. Methods: It is a retrospective, comparative study of 6 mo, conducted at Shadan Institute of Medical Sciences, Hyderabad. 300 diabetic patients of age group between 30-85 y of either gender were divided into Group-A, receiving metformin and Group-B, receiving metformin+DPP-4 inhibitors. Ethics committee approval was o btained. The baseline and after 6 mo values of Vitamin B12 were noted and analyzed by using SPSS software. Results: The majority of the patients were from the age group of 56-65 y (n=42, 28%) in Group-A and 46-55 y (n=61, 40.7%) in Group B. Male predominance was observed in both groups (n=81, 54% and n=76, 50.7%). Duration of Diabetes mellitus was ≤5 y in both groups (n=87, 58% and n=112, 74.7%). Vitamin B12 mean values for Group-A (Baseline-478.61, After 6 mo-195.94) and Group-B (Baseline-527.82, After 6 mo-299.05) were obtained. Mean reduction with a statistical significance in both study groups was observed (Group-A-282.66 and Group-B-228.77). Most of the patients showed numbness (14%) in Group-A and general weakness (7.3%) in Group B, respectively. Conclusion: Type 2 diabetic patients who were on metformin therapy only have a prevalence of vitamin B12 deficiency compared to Metformin in combination with DPP-4 inhibitors receiving patients.

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“…It is similar to a study done by Agarwal P et al, in 2016, where the mean duration of T2DM was around 6.15 y [13].…”

Section: Discussionsupporting

confidence: 90%

Comparative Study of Vitamin B12 Deficiency Associated With Metformin and Metformin in Combination With DPP-4 Inhibitors in a Tertiary Care Hospital

MISBAH,

SIDDIQUA,

MASOOD

et al. 2023

Int J Pharm Pharm Sci

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“…RBC showing volume ≥100 fl is termed as macrocyte that occurs due to the deficiency of folic acid and cobalamin. 1,2 Macrocytes RBC are large in size and are hemolyzed as they pass through microcirculation whose diameter is less than these. Hemolysis is common in the sinusoids of liver and spleen.…”

Section: Introductionmentioning

confidence: 99%

“…A sample of 450 cases of macrocytic anemia was calculated 'sampling for proportions' and included in study protocol. RBC showing raised mean corpuscular volume (MCV) ≥100 fl, termed as macrocyte was inclusion criteria for analyzing blood cobalamin levels 1,2. Diagnosis was made by consultant hematologist.…”

mentioning

confidence: 99%

Vitamin Cobalamin deficiency in macrocytic anemia reporting at a Tertiary Care Hospital.

Shaikh¹,

Shaikh²,

Tabassum³

et al. 2021

TPMJ

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Objective: Determine the frequency of vitamin cobalamin deficiency in macrocytic anemia cases reporting at tertiary care hospital. Study Design: Cross Sectional study. Setting: Faculty of Medicine and Allied Medical Sciences, Isra University, Hyderabad, Sindh Pakistan. Period: January 2017 to October 2018. Material & Methods: 450 cases of both genders, diagnosed as macrocytic- megaloblastic anemia were studied for the vitamin Cobalamin levels. Cases were collected through non- probability convenient sampling by inclusion and exclusion criteria. Consenting volunteers were asked for blood sampling. 5 mL blood was taken from ante – cubital fossa. Samples were centrifuged and sera were collected for the estimation of vitamin cobalamin by ELISA – assay kit. Continuous and categorical variables were entered in SPSS (version 21.0) and analyzed by Student t-test and Chi-square test respectively at 95% CI (P ≤ 0.05). Results: Male and female comprised 225 (43.3%) and 294 (56.6%) of 519 subjects. Male to female ratio was noted 1.30:1. MCV, MCH and MCHC show statistically significant difference between male and female (P<0.05). MCV in male was 96.8±9.92 fl vs. 105.5±12.04 fl in female (P=0.0001). Normal cobalamin was noted in 15.2% (n= 79) and any type of cobalamin deficiency was noted in 84.7% (n= 440) (P=0.0001). Conclusion: The present study reports frequency of 84.7% Cobalamin deficiency in macrocytic anemia reporting at Indus Medical College Hospital. Further studies are recommended by the treating physicians.

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“…19,20 A significant correlation was found between metformin use in treatment of T2DM and low vitamin B12 levels in various studies and recommended determination and supplementation of vitamin B12. [23][24][25] The mean level of vitamin B12 in 124 patients was 365.02±190.6 pg/ml. Definite deficiency of vitamin B12 (<200 pg/ml) in 19.4% patients in this study was showing higher prevalence compared to 5.8%, 8.6 % and 6.3% in other studies.…”

Section: Discussionmentioning

confidence: 99%

Vitamin B12 deficiency in patients of type 2 diabetes mellitus treated with metformin: a cross section observational study from a tertiary care centre in Sub-Himalayan region of North India

et al. 2020

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Background: Metformin is first line of treatment in type 2 diabetes mellitus (T2DM). It has been reported to be associated with vitamin B12 deficiency with variable results in various studies. The aim of our study is to correlate metformin use and vitamin B12 levels in patients of T2DM with high prevalence in Sub-Himalyan region of north India.Methods: The study was conducted from August 2017 to July 2018 enrolling 124 patients, aged 18 years and above with T2DM taking metformin treatment for >4 months. Vitamin B12 levels were estimated and the levels <200, 200-300 and >300 pg/ml were defined as having definite deficiency, borderline deficiency and normal levels respectively.Results: A total of 124 patients included 66 (53.2%) male and 58 (46.8%) female patients with T2DM on metformin treatment. The mean vitamin B12 level was found significantly low, 176.23±60.96 pg/ml and 18 (14.5%) patients were found to have significant vitamin B12 deficiency and 8(6.5%) patients, borderline deficiency in longer duration of metformin use for >10 years (p<0.001). Vitamin B12 deficiency was found significantly more in 14 (11.3%) patients taking lower doses ≤1000 mg/day of metformin compared to higher doses, a negative correlation. Peripheral neuropathy was significantly present in 15.3% of patients in metformin induced vitamin B12deficiency.Conclusions: Vitamin B12 deficiency was found to be significantly correlated to longer duration of metformin treatment and neuropathy in T2DM but negatively correlated to higher doses of metformin. Therefore, we recommend the assessment and supplementation of vitamin B12 in metformin use in T2DM, compromising financial burden but not the outcome of its deficiency.

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A comparative study of levels of vitamin B12 in patients of type 2 diabetes mellitus on metformin and not on metformin at tertiary care center

Cited by 9 publications

References 17 publications

Comparative Study of Vitamin B12 Deficiency Associated With Metformin and Metformin in Combination With DPP-4 Inhibitors in a Tertiary Care Hospital

Comparative Study of Vitamin B12 Deficiency Associated With Metformin and Metformin in Combination With DPP-4 Inhibitors in a Tertiary Care Hospital

Vitamin Cobalamin deficiency in macrocytic anemia reporting at a Tertiary Care Hospital.

Vitamin B12 deficiency in patients of type 2 diabetes mellitus treated with metformin: a cross section observational study from a tertiary care centre in Sub-Himalayan region of North India

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