The Prevalence of Vitamin B12 Deficiency in Patients with Type 2 Diabetes: A Cross-Sectional Study

Pflipsen, Matthew; Oh, Robert C.; Saguil, Aaron; Seehusen, Dean A.; Seaquist, Derek; Topolski, Richard

doi:10.3122/jabfm.2009.05.090044

Cited by 161 publications

(153 citation statements)

References 29 publications

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“…Other studies have examined B 12 status in individuals randomly selected from the population (10,16,17) . Allen showed in a US sub-population of individuals aged $60 years that the prevalence of B 12 deficiency was 6 % and the prevalence of B 12 depletion (marginal B 12 status, HoloTC not assessed) was about 20 % (4) .…”

Section: Discussionmentioning

confidence: 99%

Prevalence of vitamin B12 depletion and deficiency in Liechtenstein

Koenig

Stanga

Zerlauth

et al. 2012

Public Health Nutr.

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Objective: Data about vitamin B 12 (B 12 ) deficiency in the general population are scarce. The present study was performed to determine the prevalence of B 12 deficiency in the general population of the Principality of Liechtenstein, as well as to identify sub-populations potentially at high risk. Design: Retrospective study. Setting: Ambulatory setting, population of the Principality of Liechtenstein. Subjects: Seven thousand four hundred and twenty-four patients seeking medical attention whose serum samples were referred for routine work-up in an ambulatory setting were consecutively enrolled. Serum total B 12 was determined in all patients in this cohort. In addition, for a subgroup of 1328 patients, serum holotranscobalamin was also measured. Prevalence of B 12 deficiency was calculated. Further, multivariate logistical regression models were applied to identify covariates independently associated with B 12 deficiency and depletion. Results: Nearly 8 % of the general population was suffering from either B 12 depletion or deficiency. The ratio between B 12 depletion and deficiency was 2:1 for all age ranges. Pathological changes were detected predominantly in older people. Female gender was a significant predictor of B 12 depletion. In the cohort, nearly 40 % exhibited either depletion or deficiency of B 12 . Conclusions: B 12 depletion and deficiency are common in Liechtenstein, a Central European country. The measurement of biochemical markers represents a costefficient and valid assessment of the B 12 state. When a deficiency of B 12 is diagnosed at an early stage, many cases can be treated or prevented, with beneficial effects on individual outcomes and subsequent potential reductions in health-care costs.

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Section: Discussionmentioning

confidence: 99%

Prevalence of vitamin B12 depletion and deficiency in Liechtenstein

Koenig

Stanga

Zerlauth

et al. 2012

Public Health Nutr.

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“…21 . Metformin may also inhibit the calcium dependent absorption of the vitamin B 12 and intrinsic factor complex at the terminal ileum. This inhibitory effect could be reversed with calcium supplementation 22 .…”

Section: Clinical Studies Of Vitamin B 12 Deficiency In Indian Populamentioning

confidence: 99%

“…Vitamin B 12 should be given either by oral or parenteral route in case of deficiency. 27 Both oral and parenteral formulations can produce comparable improvements in symptoms of vitamin B 12 deficiency regardless of its aetiology 28 .…”

Section: Treatment Of Vitamin B 12 Deficiency Among Diabetic Patientsmentioning

confidence: 99%

“…Other side effects like abdominal distress and diarrhoea 5 appear within first few days' of initiation of metformin but disappear after discontinuation of metformin therapy. However, malabsorption of vitamin B 12 may not be easily diagnosed without close attention. Various studies have reported that an average of 10-30 % of patients taking metformin for longer duration and at higher dosage have shown vitamin B 12 deficiency [6][7][8][9] .…”

Section: Introductionmentioning

confidence: 99%

“…Clinical manifestations of vitamin B 12 deficiency include alteration in mental status, megaloblastic anemia and neurological damage 7,10,11 . However, diabetic neuropathy can also present with symptoms such as paresthesias, numbness and tingling in hands and feet etc 12 . These symptoms could give rise to confusion between diagnosis of peripheral neuropathy due to vitamin B 12 deficiency and diabetic peripheral neuropathy 10,11 .…”

Section: Introductionmentioning

confidence: 99%

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Metformin Use and Vitamin B<SUB>12</SUB> Deficiency in Patients with Type-2 Diabetes Mellitus

Singh¹,

Baheti²

2016

MVP J Med Sci

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Metformin is commonly used oral hypoglycaemic agent in the treatment of type-2 Diabetes Mellitus (DM). One of the important side effect of long term metformin therapy is malabsorption of vitamin B 12 which could lead to megaloblastic anemia and peripheral neuropathy. Therefore annual screening of serum vitamin B 12 level or serum methylmalonic acid (MMA)/serum homocysteine level should be done in cases taking metformin for more than four to five years with average dose of >1g per day, even in the absence of haematological or neurological abnormalities. However, as the incidence of type-2 DM is increasing, cost of annual measurement of vitamin B 12 level also increases. Considering cost factor for annual screening, vitamin B 12 supplementation appears to be more cost effective approach rather than annual screening for routine prophylaxis. Routine vitamin preparations available in the market may contain less amount of B 12 and hence are not of much therapeutic use in treatment of B 12 deficiency due to Metformin. Hence there is a need to look for higher doses of approximately 500-2000μg/day.

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Proton Pump Inhibitor and Histamine 2 Receptor Antagonist Use and Vitamin B₁₂Deficiency

Lam

Schneider

Zhao

et al. 2013

JAMA

483

154

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itamin B 12 deficiency is relatively common, especially among older adults; it has potentially serious medical complications if undiagnosed. Left untreated, vitamin B 12 deficiency can lead to dementia, neurologic damage, anemia, and other complications, which may be irreversible. According to data from the National Health and Nutrition Examination Survey, 3.2% of adults older than 50 years are estimated to have low serum vitamin B 12 levels. 1 Other studies have reported prevalence rates of 5% to 15%, although these may be underestimates of the true prevalence in some population subgroups. 2,3 Thus, identifying modifiable risk factors for vitamin B 12 deficiency is of significant public health importance. Acid inhibitors are among the most commonly used pharmaceuticals in the United States. In 2012, 14.9 million patients received 157 million prescriptions for proton pump inhibitors (PPIs); thus, use of PPIs could theoretically increase the population's risk of vitamin B 12 deficiency. 4 Gastric acid is required to cleave vitamin B 12 from ingested dietary proteins for the essential vitamins to be absorbed, and it is produced by the same cells that produce intrinsic factor, a compound required for vitamin B 12 absorption. 5 Thus, PPIs and histamine 2 receptor antagonists (H 2 RAs), which suppress the production of gastric acid, may lead to malabsorption of vitamin B 12. IMPORTANCE Proton pump inhibitors (PPIs) and histamine 2 receptor antagonists (H 2 RAs) suppress the production of gastric acid and thus may lead to malabsorption of vitamin B 12. However, few data exist regarding the associations between long-term exposure to these medications and vitamin B 12 deficiency in large population-based studies. OBJECTIVE To study the association between use of PPIs and H 2 RAs and vitamin B 12 deficiency in a community-based setting in the United States. DESIGN, SETTING, AND PATIENTS We evaluated the association between vitamin B 12 deficiency and prior use of acid-suppressing medication using a case-control study within the Kaiser Permanente Northern California population. We compared 25 956 patients having incident diagnoses of vitamin B 12 deficiency between January 1997 and June 2011 with 184 199 patients without B 12 deficiency. Exposures and outcomes were ascertained via electronic pharmacy, laboratory, and diagnostic databases. MAIN OUTCOMES AND MEASURES Risk of vitamin B 12 deficiency was estimated using odds ratios (ORs) from conditional logistic regression. RESULTS Among patients with incident diagnoses of vitamin B 12 deficiency, 3120 (12.0%) were dispensed a 2 or more years' supply of PPIs, 1087 (4.2%) were dispensed a 2 or more years' supply of H 2 RAs (without any PPI use), and 21 749 (83.8%) had not received prescriptions for either PPIs or H 2 RAs. Among patients without vitamin B 12 deficiency, 13 210 (7.2%) were dispensed a 2 or more years' supply of PPIs, 5897 (3.2%) were dispensed a 2 or more years' supply of H 2 RAs (without any PPI use), and 165 092 (89.6%) had not received prescriptions for eithe...

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The Prevalence of Vitamin B12 Deficiency in Patients with Type 2 Diabetes: A Cross-Sectional Study

Cited by 161 publications

References 29 publications

Prevalence of vitamin B12 depletion and deficiency in Liechtenstein

Prevalence of vitamin B12 depletion and deficiency in Liechtenstein

Metformin Use and Vitamin B<SUB>12</SUB> Deficiency in Patients with Type-2 Diabetes Mellitus

Proton Pump Inhibitor and Histamine 2 Receptor Antagonist Use and Vitamin B₁₂Deficiency

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The Prevalence of Vitamin B12 Deficiency in Patients with Type 2 Diabetes: A Cross-Sectional Study

Cited by 161 publications

References 29 publications

Prevalence of vitamin B12 depletion and deficiency in Liechtenstein

Prevalence of vitamin B12 depletion and deficiency in Liechtenstein

Metformin Use and Vitamin B<SUB>12</SUB> Deficiency in Patients with Type-2 Diabetes Mellitus

Proton Pump Inhibitor and Histamine 2 Receptor Antagonist Use and Vitamin B12Deficiency

Contact Info

Product

Resources

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Proton Pump Inhibitor and Histamine 2 Receptor Antagonist Use and Vitamin B₁₂Deficiency