Serum vitamin B12 levels in type 2 diabetes patients on metformin compared to those never on metformin: A cross-sectional study

Raizada, Nishant; Jyotsna, Viveka P; Sreenivas, Vishnubhatla; Tandon, Nikhil

doi:10.4103/ijem.ijem_529_16

Cited by 28 publications

(14 citation statements)

References 15 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…This study suggests that vitamin B12 deficiency is highly prevalent in our population (7% of patients); however, it is not as high as described in some recent studies showing prevalence from 28 to 41% (18, 19, 20, 21). A recently published meta-analysis found that the use of metformin is a risk factor for vitamin B12 deficiency in diabetic patients (22).…”

Section: Discussionsupporting

confidence: 45%

Vitamin B12 deficiency and diabetic neuropathy in patients taking metformin: a cross-sectional study

Alvarez

Sierra

Saavedra

et al. 2019

Endocrine Connections

View full text Add to dashboard Cite

Objective Vitamin B12 deficiency resulting from metformin use has been demonstrated in multiple studies. In this study, we aimed to evaluate the prevalence of vitamin B12 deficiency in patients with chronic metformin use and the relationship between vitamin B12 deficiency and diabetic neuropathy. Methods A cross-sectional study was conducted with 162 patients. Vitamin B12 levels were measured by chemiluminescence immunoassay. Diabetic neuropathy was evaluated by patient record, nerve conduction and Michigan test for the diagnosis of diabetic neuropathy. Additional data, including demographic characteristics were collected. A linear regression model was used to evaluate variables that correlated with vitamin B12 levels and diabetic neuropathy. Results Low vitamin B12 levels were found in 7.3% (95% CI: 4.0–12%) of patients. In those with diabetic neuropathy, altered (low and borderline) vitamin B12 level was 64% (95% CI: 47–78%) compared to 17% (95% CI: 10–26%) in patients without diabetic neuropathy (coefficient: −110.8; CI 95%: −165.8, −59.7). Those taking a higher metformin dose had lower levels of vitamin B12 (coefficient: −0.061; CI 95%: −0.09, −0.024). In addition, female patients had higher levels of vitamin B12 compared to men (coefficient: 49.1; CI 95%: 2.3–95). Conclusions Vitamin B12 deficiency is highly prevalent, especially in patients with diabetic neuropathy. In this study an inverse correlation was found between diabetic neuropathy and the plasma level of vitamin B12. Higher doses of metformin and male sex were factors related to lower levels of vitamin B12.

show abstract

Section: Discussionsupporting

confidence: 45%

Vitamin B12 deficiency and diabetic neuropathy in patients taking metformin: a cross-sectional study

Alvarez

Sierra

Saavedra

et al. 2019

Endocrine Connections

View full text Add to dashboard Cite

show abstract

“…reported no difference between vitamin B12 levels in people with diabetes taking metformin or without it. [20] Serum Vitamin B12 levels were 267.7 ± 194.4 pmol/l in metformin group and 275.1 ± 197.2 pmol/l in the no metformin group ( P = 0.78). [20] In current study, almost all patients enrolled with diabetes were on metformin and therefore no comparison could be done to delineate effect of metformin.…”

Section: Discussionmentioning

confidence: 99%

“…[20] Serum Vitamin B12 levels were 267.7 ± 194.4 pmol/l in metformin group and 275.1 ± 197.2 pmol/l in the no metformin group ( P = 0.78). [20] In current study, almost all patients enrolled with diabetes were on metformin and therefore no comparison could be done to delineate effect of metformin. Discrepancy between Indian and western literature may be due to huge difference in prevalence of vitamin B12 deficiency among general population.…”

Section: Discussionmentioning

confidence: 99%

Vitamin B12 deficiency is endemic in Indian population: A perspective from North India

Singla

Garg

Surana

et al. 2019

Indian J Endocr Metab

View full text Add to dashboard Cite

Background: Vitamin B12 deficiency is believed to be widespread in Indian population. However, more data is needed to fuel a meaningful debate on preventive and therapeutic strategies. Aims and Objectives: Objective of the current study is to evaluate status of vitamin B12 levels in people from a tier 3 city and among people living in an urban area with or without diabetes. Settings and Design: Retrospective, cross-sectional study. Methodology: Data captured in electronic medical records (EMR) of an endocrine practice and from a diagnostic laboratory was analysed. Statistical Analysis Used: Statistical analysis was done using open source software “Jamovi”. Results: Prevalence of vitamin B12 deficiency (Vitamin B12 levels <200 pg/ml) in tier 3 city was 47.19% ( n = 267). From an urban endocrine practice, database of 11913 patients was searched for reports of vitamin B12 levels. Prevalence of vitamin B12 deficiency was 37.76% in people with pre-diabetes ( n = 92), 31.23% in people with endocrine problems other than diabetes and pre-diabetes ( n = 285) and 18.25% in people with diabetes ( n = 378). Tier 3 city population had significantly lower vitamin B12 levels than people living in an urban area and attending an endocrine clinic. Vitamin B12 levels were significantly higher in people with diabetes as compared to people with other endocrine problems. Conclusion: Prevalence of vitamin B12 deficiency is 47% in north Indian population. People with diabetes have higher vitamin B12 levels than general population though still have high prevalence of deficiency. This data shows that Vitamin B12 deficiency is widespread in Indian population.

show abstract

“…In a study conducted by Raizada et al, no significant increase in the prevalence of neuropathy was found in vitamin B12-deficient patients compared with patients with normal vitamin B12 levels. They emphasized that the increased the duration of diabetes was associated with the severity of vitamin B12 deficiency [ 13 ].…”

Section: Discussionmentioning

confidence: 99%

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

Olt

Oznas

2017

North Clin Istanbul

View full text Add to dashboard Cite

OBJECTIVE:The relationship between vitamin B12 deficiency and peripheral neuropathy has been shown in a number of previous studies. Metformin is the indispensable first-line treatment for type 2 diabetes mellitus (DM) worldwide. One of the adverse effects of the use of metformin is vitamin B12 deficiency. In the present study, we investigated the relationship between vitamin B12 deficiency and peripheral neuropathy due to the use of metformin.METHODS:Patient’s laboratory and electromyography (EMG) data were retrospectively reviewed. Patients with no EMG report and other necessary information were excluded from the study.RESULTS:Eighty-six patients with type 2 DM using metformin were included in the study. Of these patients, 26 were males and 60 were females. The mean age of the patients was 55.1±7.7 years. The mean body mass index of the patients was 29.1±9.01 kg/m2. The mean HbA1c level of the patients was 8.6%±2.1%. The mean duration of diabetes was 8.02±5.4 years. The incidence of vitamin B12 deficiency was 38.4%. Peripheral neuropathy was detected in 33.7% patients. There was no statistically significant difference in vitamin B12 levels between patients with peripheral neuropathy and those without peripheral neuropathy (p=0.64).CONCLUSION:Therefore, it can be concluded that the lack of vitamin B12 secondary to the use of metformin did not significantly increase the frequency of peripheral neuropathy.

show abstract

Serum vitamin B12 levels in type 2 diabetes patients on metformin compared to those never on metformin: A cross-sectional study

Cited by 28 publications

References 15 publications

Vitamin B12 deficiency and diabetic neuropathy in patients taking metformin: a cross-sectional study

Vitamin B12 deficiency and diabetic neuropathy in patients taking metformin: a cross-sectional study

Vitamin B12 deficiency is endemic in Indian population: A perspective from North India

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

Contact Info

Product

Resources

About