An observational study of vitamin b12 levels and peripheral neuropathy profile in patients of diabetes mellitus on metformin therapy

Gupta, Kamesh; Jain, Anand; Rohatgi, Anurag

doi:10.1016/j.dsx.2017.08.014

Cited by 45 publications

(48 citation statements)

References 29 publications

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“…In contrast, in our results no relationship was seen between metformin use duration and Vitamin B12. This finding is in line with Gupta et al, [22] where an inverse relationship between metformin use duration and Vitamin B12 level. Similarly, Metaxas et al, [20] report diabetes as effective factors on Vitamin B12 level, which is parallel with results of present study.…”

Section: Discussionsupporting

confidence: 92%

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An Investigation on Vitamin B12 Serum Levels among Type 2 Diabetic Patients Treated with Metformin Compared to Normal Levels

Samadanifard

Eskandari

Khodabandehloo

et al. 2020

JPRI

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Background: Given the increasing prevalence of type 2 diabetes in the community and the use of metformin as one of its most common therapies as well as presence of some evidences on a link between the use of this medicine and vitamin B12 levels, we decided to measure and compare serum level of vitamin B12 among the diabetic patients under treatment by metformin and compare with its natural content. Decreased Vitamin B12 levels leads to some clinical problems including anemia, gastrointestinal disorders (diarrhea, constipation, decreased appetite, etc.,), neurological disorders (tingle, numbness, muscle weakness, etc.,) and mental disorders (memory impairment, depression, behavioral problems, etc.,). Therefore, we would determine if the duration of metformin use and dosage may be effective on serum levels of vitamin B12 among metformin-treated diabetic patients. Methods: Serum vitamin B12 level in metformin-treated type 2 diabetic patients referred to Rasoul-e-Akram Hospital and Specialist Clinic of Taban in Tehran in 2016 (306 subjects selected by convenience sampling) was determined and then compared to its normal level. Results: Of the 306 participants in the study, 120 ones were females (39.2%) and 186 ones were males (60.8%). Also, 150 ones (49%) were healthy and 156 ones (51%) were suffering from diabetes Miletus. There was a significant difference between the type 2 diabetes mellitus and healthy individuals with quantitative variables such as age, height, weight, BMI, serum cholesterol (Chol) level, LDL serum level, HDL serum level, triglyceride (TG) level. The mean blood level of Vitamin B12 level was 448.92±156.75pg/mL among all participants. A Vitamin B12 deficiency frequency of above 6% was seen among diabetic patients. In regression analysis, a model was defined based on which age, gender, diabetes and Metformin used had a significant effect on serum levels of vitamin B-12. Also, none of the variables gender, age, duration of treatment, metformin quantity, weight and BMI was associated with a deficiency of vitamin B12. Conclusion: In the diabetic group, the prevalence of Vitamin B12 deficiency was more than6%. It was also seen that age, gender, diabetes mellitus, metformin intake and metformin content had a significant effect on serum B12 levels. Therefore, measurement of serum levels of vitamin B12 in metformin-treated subjects is recommended.

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Section: Discussionsupporting

confidence: 92%

“…Besides, in a new study conducted on mice, accumulation of Vitamin B12 is reported in liver and kidney, indicating low vitamin B12 serum level [12]. Another justification for B12 deficiency following metformin use is its effect on calciumdependent membrane function in the terminal part of the ileum [22].…”

Section: Discussionmentioning

confidence: 99%

An Investigation on Vitamin B12 Serum Levels among Type 2 Diabetic Patients Treated with Metformin Compared to Normal Levels

Samadanifard

Eskandari

Khodabandehloo

et al. 2020

JPRI

View full text Add to dashboard Cite

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“…To complicate matters, medications commonly used for treatment of diet‐ and lifestyle‐related conditions may contribute to neuropathy (Fig. ) . Some medications, such as proton‐pump inhibitors, H2 blockers, and metformin, are associated with reduced absorption of B vitamins .…”

Section: Medication‐induced Nutrient Depletion and Neuropathymentioning

confidence: 99%

“…39,[47][48][49][50][51][52] Some medications, such as proton-pump inhibitors, H2 blockers, and metformin, are associated with reduced absorption of B vitamins. 49,[51][52][53][54] Drug-induced nutrient depletion is more common than has been previously acknowledged. 55 For those of older age, there is often a concomitant use of medications that contribute to nutrient depletion in addition to having a decreased ability to absorb vitamin B 12 due to reduced stomach acid.…”

Section: Medication-induced Nutrient Depletion and Neuropathymentioning

confidence: 99%

Integrative neuromuscular medicine: Neuropathy and neuropathic pain: Consider the alternatives

Rowin

2019

Muscle and Nerve

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Complementary and alternative treatment modalities are commonly utilized by patients for neuropathy and neuropathic pain due to perceived lack of benefit from conventional medical treatment. As the association between metabolic syndrome and neuropathy is increasingly recognized, diet and lifestyle interventions are becoming important components in the management of neuropathy. Progress in the understanding of the gut–immune interaction highlights the role the gut microbiome and inflammation plays in the modulation of neuropathy and neuropathic pain. Evidence for nutritional interventions, exercise, supplements, acupuncture, and mindfulness‐based practices in the treatment of neuropathic pain is encouraging. This article reviews the available evidence to support the safe use of complementary and alternative treatments for commonly encountered conditions associated with neuropathy and neuropathic pain. Muscle Nerve 60: 124–136, 2019

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“…Однако авторы не выявили достоверных различий в уровне витамина В 12 между группами с полинейропатией и без нее. Кроме того, по результатам двух других исследований [17,18] было отме-чено, что у пациентов с СД2, длительно принимающих метформин, достоверно чаще встречалась полинейропатия и степень ее тяжести согласно Торонтской шкале оценки нейропатии достоверно коррелировала с дозировкой и длительностью приема метформина. Таким образом, пациенты, продолжительное время принимающие метфомин, имеют повышенный риск развития дефицита витамина В 12 и, соответственно, риск развития В 12 -дефицитной полинейропатии.…”

Section: недиабетические полинейропатииunclassified

Diabetic and non-diabetic neuropathies in patients with diabetes mellitus

Ахмеджанова

Баринов

Строков

2018

Z. nevrol. psikhiatr. im. S.S. Korsakova

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Diabetic polyneuropathy is the most often complication of diabetes mellitus. However, patients with diabetes may have other neuropathies, which need to be recognized and treated. Chronic nnflammatory demyelinating polyneuropathy is the most common non-diabetic polyneuropathy in patients with diabetes. The article discusses the classification, clinical features of diabetic and nondiabetic polyneuropathies, modern methods of diagnosis and approaches to treatment.

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An observational study of vitamin b12 levels and peripheral neuropathy profile in patients of diabetes mellitus on metformin therapy

Cited by 45 publications

References 29 publications

An Investigation on Vitamin B12 Serum Levels among Type 2 Diabetic Patients Treated with Metformin Compared to Normal Levels

An Investigation on Vitamin B12 Serum Levels among Type 2 Diabetic Patients Treated with Metformin Compared to Normal Levels

Integrative neuromuscular medicine: Neuropathy and neuropathic pain: Consider the alternatives

Diabetic and non-diabetic neuropathies in patients with diabetes mellitus

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