Impact of type 2 Diabetes and Metformin use on Vitamin B12 Associated Biomarkers - an Observational Study

Metaxas, Corina; Zurwerra, Chantal; Rudofsky, Gottfried; Hersberger, Kurt E.; Walter, Philipp

doi:10.1055/s-0043-120760

Cited by 4 publications

(6 citation statements)

References 45 publications

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“…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%

“…In Metaxas et al, study [20], Vitamin B12 deficiency was considered to be below 200 ng/mL based on which a frequency of 34% was reported. Also, the relationship between Vitamin B12 serum level and metformin has been demonstrated formerly [21] which is in line with findings of present study.…”

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

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“…and their relationship with PN (Neuropathy Symptom Score [NSS] and Neuropathy Disability Score [NDS]), no significant differences were found between vitamin B12 and homocysteine levels in patients with mild, moderate, or severe PN [16].…”

Section: Resultsmentioning

confidence: 99%

“…Another important factor for the results found were the methods for measuring vitamin B12 deficiency. Reduced levels of holotranscobalamin and increased levels of homocysteine can be considered as the best markers for vitamin B12 deficiency, especially in the older population, being more suggestive of tissue deficiency of the vitamin [10,16,18].…”

Section: Discussionmentioning

confidence: 99%

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Vitamin B12 Deficiency and Peripheral Neuropathy in patients with Type 2 Diabetes Mellitus Treated with Metformin. An integrative review

Dias¹,

Pereira²,

Orrico³

2023

Braz. J. Hea. Rev.

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Background/Purpose: Type 2 diabetes mellitus (T2DM) is a worldwide pathology with several complications, and 50% of patients with T2DM develop peripheral neuropathy (PN) in the long term. The present study aimed to review the literature on the association between PN and vitamin B12 deficiency in patients with T2DM treated with metformin. Materials and methods: A literature review was carried out in the PubMed Central, Cochrane, Scielo, Scopus and Embase databases, from 2015 to 2021. We found 755 studies, of which 16 were included. Results: The serum level of vitamin B12 was lower in individuals with at least one neurological symptom. Treatment with metformin was associated with reduced serum vitamin B12 levels, and its use was defined as a probable cause of PN due to reduced vitamin B12. Studies that performed supplementation with methylcobalamin demonstrated significant improvement in neuropathic symptoms. Vitamin B12 supplementation therapy for diabetic patients undergoing metformin treatment has been suggested. Conclusion: Deficiency of vitamin B12 associated to metformin can be considered a risk factor for PN. Periodically evaluation of serum levels of vitamin B12 is recommended for patients on metformin treatment.

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Vitamin B12 and Folate Concentrations in Recent-onset Type 2 Diabetes and the Effect of Metformin Treatment

Kanti

Anadol-Schmitz

Bobrov

et al. 2020

The Journal of Clinical Endocrinology &Amp; Metabolism

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Context Vitamin B12 and folate deficiency are not only linked to hematological, neurological, and cardiovascular diseases, but are also associated with insulin resistance. Metformin can decrease vitamin B12 and folate concentrations. Objective To examine (1) effects of short-term metformin treatment on serum holotranscobalamin (holoTC) and folate and (2) their association with insulin sensitivity in recent-onset type 2 diabetes. Design This cross-sectional analysis comprised patients (known disease duration <12 months) on metformin monotherapy (MET, n = 123, 81 males, 53 ± 12 years) or nonpharmacological treatment (NPT, n = 126, 77 males, 54 ± 11 years) of the German Diabetes Study. Main Outcome Measures HoloTC (enzyme-linked immunosorbent assay), cobalamin, and folate (electrochemiluminescence); beta-cell function and whole-body insulin sensitivity, measured during fasting (HOMA-B, HOMA-IR) and intravenous glucose tolerance tests combined with hyperinsulinemic–euglycemic clamp tests. Results HoloTC (105.4 [82.4, 128.3] vs 97 [79.7, 121.9] pmol/L) and folate concentrations (13.4 [9.3, 19.3] vs 12.7 [9.3, 22.0] nmol/L) were similar in both groups. Overall, holoTC was not associated with fasting or glucose-stimulated beta-cell function and insulin-stimulated glucose disposal. Cobalamin measurements yielded similar results in representative subgroups. In NPT but not MET, folate levels were inversely correlated with HOMA-IR (r = –0.239, P = .007). Folate levels did not relate to insulin sensitivity or insulin secretion in the whole cohort and in each group separately after adjustment for age, body mass index, and sex. Conclusions Metformin does not affect circulating holoTC and folate concentrations in recent-onset type 2 diabetes, rendering monitoring of vitamin B12 and folate dispensable, at least during the first 6 months after diagnosis or initiation of metformin.

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Impact of type 2 Diabetes and Metformin use on Vitamin B12 Associated Biomarkers - an Observational Study

Cited by 4 publications

References 45 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

Vitamin B12 Deficiency and Peripheral Neuropathy in patients with Type 2 Diabetes Mellitus Treated with Metformin. An integrative review

Vitamin B12 and Folate Concentrations in Recent-onset Type 2 Diabetes and the Effect of Metformin Treatment

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