Metformin Use Is Not Associated With B12 Deficiency or Neuropathy in Patients With Type 2 Diabetes Mellitus in Qatar

Elhadd, Tarik; Ponirakis, Georgios; Dabbous, Zeinab; Siddique, Mashhood A.; Chinnaiyan, Subitha; Malik, Rayaz A.

doi:10.3389/fendo.2018.00248

Cited by 29 publications

(35 citation statements)

References 32 publications

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“…While most studies, including meta-analysis reviews, agree that there is an association between vitamin B12 deficiency and the intake of metformin in T2DM patients, a small number of studies have disputed this relationship. 4,5,15,16 The current study confirmed the association between a high metformin dose and vitamin B12 deficiency as concluded by previous studies. 3,10 Patients were found to be at a higher risk of developing vitamin B12 deficiency if they took a larger dose of metformin (>2000 mg/day) and for a longer duration (>4 years).…”

Section: Discussionsupporting

confidence: 91%

Vitamin B12 Deficiency in Diabetic Patients on Metformin Therapy: A cross-sectional study from Oman

Al-Hamdi

Al-Gahhafi

Al-Roshdi

et al. 2020

Sultan Qaboos Univ Med J

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Objectives: This study aimed to determine the prevalence of vitamin B12 deficiency amongst diabetic patients on metformin therapy. Methods: This cross-sectional study was conducted at general clinics at the University Health Center and diabetes outpatient clinics at Sultan Qaboos University Hospital, Muscat, Oman, between January and December 2017. All Omani adults who were diagnosed with type 2 diabetes mellitus and took metformin were invited to participate in the study. The variables included in this study were age, gender, duration of diabetes, dose and duration of metformin therapy, haemoglobin and glycosylated haemoglobin level. Results: A total of 248 subjects were included (response rate = 95.4%) of which 26 (10.5%) were vitamin B12 deficient and 53 (21.4%) were borderline deficient. The mean daily dose of metformin was highest among vitamin B12 deficient group (1,981 ± 222 mg; P = 0.004). Conclusion: The prevalence of vitamin B12 deficiency is considerable among diabetic patients on metformin therapy. Further research is needed to confirm the need for routine screening and monitoring.Keywords: Type 2 Diabetes Mellitus; Prevalence; Metformin; Vitamin B12 Deficiency; Oman.

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Section: Discussionsupporting

confidence: 91%

Vitamin B12 Deficiency in Diabetic Patients on Metformin Therapy: A cross-sectional study from Oman

Al-Hamdi

Al-Gahhafi

Al-Roshdi

et al. 2020

Sultan Qaboos Univ Med J

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“…Concern has been raised regarding metformin‐associated vitamin B 12 deficiency and peripheral neuropathy; however, a recent meta‐analysis has shown that, whilst long‐term metformin use is associated with vitamin B 12 deficiency, it is not related to an increased prevalence of DPN . Furthermore, we have recently shown that the prevalence and severity of DPN and painful DPN were similar in people with and without B 12 deficiency .…”

Section: Treatment Of Diabetic Peripheral Neuropathymentioning

confidence: 85%

Diabetic peripheral neuropathy in people with type 2 diabetes: too little too late

et al. 2019

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Diabetic peripheral neuropathy in people with type 2 diabetes is poorly managed because of its insidious onset, delayed diagnosis and more complex aetiology resulting from the contribution of not only hyperglycaemia, but also ageing, hyperlipidaemia, hypertension and obesity. Because there is no US Food and Drug Adminstration‐approved disease‐modifying therapy for diabetic peripheral neuropathy, the key to ameliorating it in type 2 diabetes has to be through earlier diagnosis and timely multi‐factorial risk factor reduction. The management of painful diabetic peripheral neuropathy also requires a detailed appraisal of the choice of therapy, taking into account efficacy, patient wishes, comorbidities, side effect profile and potential for abuse.

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“…Some studies have also found that the administration of metformin is associated with deficiency of vitamin B 12 (VB12), whereas others have not detected such an association. Homocysteine, which is converted to methionine in the presence of VB12, is a marker for the activity of the vitamin.…”

Section: Introductionmentioning

confidence: 99%

Relationship between metformin use and vitamin B₁₂status in patients with type 2 diabetes in Japan

Sugawara

Okada

Sakaguchi

et al. 2020

J of Diabetes Invest

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Aims/Introduction: Metformin therapy has been associated with vitamin B 12 (VB12) deficiency, but information regarding this adverse effect in Asian populations is limited. We have now examined the relationship between metformin use and VB12 status in individuals with type 2 diabetes mellitus in Japan. Materials and Methods: This cross-sectional study was carried out with type 2 diabetes mellitus patients treated (Met group, n = 122) or not treated (control group, n = 63) with metformin. The primary end-point was the difference in the serum concentration of homocysteine, a marker of VB12 activity, between the two groups. The serum concentrations of VB12, blood hemoglobin level and mean corpuscular volume were also compared between the groups. Subset analysis was carried out with individuals aged ≥70 years. The potential correlation between the daily dose or duration of metformin treatment and the other measured parameters was also examined. Results: The level of homocysteine, as well as the VB12 level, hemoglobin concentration and mean corpuscular volume, did not differ significantly between the control and treated with metformin groups. The level of homocysteine was positively and that of VB12 negatively correlated with the daily dose of metformin. Among elderly individuals, the hemoglobin level was significantly lower in the treated with metformin group than in the control group, although the mean corpuscular volume was similar in the two groups. Conclusions: The risk of VB12 deficiency during metformin treatment appears to be low in Japanese type 2 diabetes mellitus patients. However, high doses of metformin might result in a moderate decrease in the circulating VB12 level, as well as in anemia in elderly individuals.

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Metformin Use Is Not Associated With B12 Deficiency or Neuropathy in Patients With Type 2 Diabetes Mellitus in Qatar

Cited by 29 publications

References 32 publications

Vitamin B12 Deficiency in Diabetic Patients on Metformin Therapy: A cross-sectional study from Oman

Vitamin B12 Deficiency in Diabetic Patients on Metformin Therapy: A cross-sectional study from Oman

Diabetic peripheral neuropathy in people with type 2 diabetes: too little too late

Relationship between metformin use and vitamin B₁₂status in patients with type 2 diabetes in Japan

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Metformin Use Is Not Associated With B12 Deficiency or Neuropathy in Patients With Type 2 Diabetes Mellitus in Qatar

Cited by 29 publications

References 32 publications

Vitamin B12 Deficiency in Diabetic Patients on Metformin Therapy: A cross-sectional study from Oman

Vitamin B12 Deficiency in Diabetic Patients on Metformin Therapy: A cross-sectional study from Oman

Diabetic peripheral neuropathy in people with type 2 diabetes: too little too late

Relationship between metformin use and vitamin B12 status in patients with type 2 diabetes in Japan

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Product

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Relationship between metformin use and vitamin B₁₂status in patients with type 2 diabetes in Japan