Vitamin B12 Deficiency among Metformin Treated Type 2 Diabetic Mellitus Patients Visiting the Department of Medicine of a Tertiary Care Centre

Abstract

Introduction: About 424.9 million people worldwide are affected by Diabetes mellitus. Prevalence among people 20–79 years old in Nepal was 4% in 2017. It is associated with microvascular and macrovascular complications such as peripheral neuropathy leading to risk of foot ulcers and amputation, and impaired sensation in their feet. The study aimed to find the prevalence of vitamin B12 deficiency among metformin-treated type 2 diabetic patients visiting the Department of Medicine of a tertiary care centre. Methods: A descriptive cross-sectional study was conducted in a tertiary care centre between 24 May 2021 to 24 May 2022 after obtaining ethical approval from the Institutional Review Committee. Patients who visited the Department of Medicine and gave informed consent were included in the study. Patients with underlying comorbidities were excluded from the study. A convenience sampling method was used. The point estimate was calculated at a 95% Confidence Interval. Results: Among 330 patients, vitamin B12 deficiency was seen in 33 (10%) (6.76-13.24, 95% Confidence Interval). Among them, 27 (81.82%) were male and 6 (18.18%) were female. Conclusions: The prevalence of vitamin B12 deficiency was found to be higher than other studies done in similar settings.

Immunomodulation through Nutrition Should Be a Key Trend in Type 2 Diabetes Treatment

“…It is requisite to conduct a meticulous interview, especially taking into account eating habits, and determine the Body Mass Index (BMI). The tests that ought to be performed in every patient with diabetes include complete blood count with a smear (lymphopenia may be an indicator of malnutrition) and the concentration of total protein, albumin, folic acid, B12, ferritin, vitamin D3, calcium, uric acid, and lipid profile [218,219,267].…”

“…Reducing vitamin B12 levels in patients with T2DM is one of the side effects of metformin use [218]. Clinical manifestations of metformin-induced vitamin B12 deficiency include hematological manifestations of megaloblastic anemia and neurological complications, i.e., peripheral neuropathy, spinal cord degeneration, and cognitive impairment [219].…”