Zhang YH, Guo W, Zeng T, Zhang S, Chen L, Gamarra M, Mansour RF, Escorcia-Gutierrez J, Huang T, Cai YD. Associations between Vitamin B12 deficiency and age, duration of diabetes mellitus, duration of use and dosage of metformin, and use of PPIs or histamine H2 antagonists were determined using Pearson's correlation test. Estimation of Serum Vitamin B12 Levels Among the Elderly Population of Wardha City: A Cross-Sectional Study. Compared with participants with normal Vitamin B12 levels, deficient participants were significantly older (64 vs. 56 years, p=0.014) and had a longer duration of metformin use (7 vs. 4 years, p=0.024). This vitamin is needed to make red blood cells, which carry oxygen to all parts of your body. Their mean daily dose of metformin was 828.13 150.52 mg (range of 5001000 mg). The use of vitamin B12 supplement was significant among patients 46 years old and above [Table 4]. 2010;43:75960, 10. Vitamin B12. Clipboard, Search History, and several other advanced features are temporarily unavailable. Russo GT, Giandalia A, Romeo EL, Scarcella C, Gambadoro N, Zingale R, Forte F, Perdichizzi G, Alibrandi A, Cucinotta D. J Endocrinol Invest. Epub 2021 Nov 24. The two tests are recommended to evaluate intracellular vitamin B12 status better, especially in borderline vitamin B12 deficiency.Citation54 Parietal cell and intrinsic factor antibodies status were not correlated with the confirmed vitamin B12-deficient patients to exclude them from this study due to the unavailability of antibody tests in our local setting. There were 107 patients (29.5%) who were on PPIs. Thats why it is said that calcium reverses the absorption of vitamin B12 and diabetes. Metformin and the gastrointestinal tract Diabetologia. Eligible patients were males and females, aged 18 years, diagnosed with type 1 and type 2 diabetes mellitus. Please enable it to take advantage of the complete set of features! Biochemical and clinical vitamin B12 deficiency has been demonstrated to be highly prevalent among patients with type 1 and type 2 diabetes mellitus. Diabetes: Fact sheet [Internet]. On average, diabetic patients should take 300 mcg of biotin, 150 mcg of B12, 1.5 mg of B1, 75 mg of B6, 25 mg of B2, and 2.5 mg of folic acid. Accessed Jan. 9, 2021. People who take metformin for type 2 diabetes have lower levels of vitamin B12. The use of vitamin B12 supplement was significantly higher among females (p < 0.001). Besides this, diabetic neuropathy will also affect the gastrointestinal tract of your body. The PubMed wordmark and PubMed logo are registered trademarks of the U.S. Department of Health and Human Services (HHS). In the human body, the small intestine is the part where absorption of Vitamin B12 takes place. Subsequently, every fifth patient in the clinic attendees was selected until the days desired sample size was reached. Accessed Jan. 9, 2021. Under normal routine, stomach cells create this protein. 2016;42:31627, 15. In diabetes, blood glucose level goes low 2014;29:96572, 13. de Jager J, Kooy A, Lehert P, Wulffele M, van der Kolk J, Bets D, et al Long-term treatment with metformin in patients with type 2 diabetes and risk of vitamin B-12 deficiency: Randomised placebo-controlled trial BMJ. It depicts that vitamin B12 absorption is a calcium-dependent process. The mean HbA1c for all patients was 8.45 2.01% (range: 4.2316.0). Results About 29.66% of diabetic patients had confirmed the B12 insufficiency through laboratory tests. Through this, not only your vitamin B12 level can be examined, but also your folate level does. The prevalence of vitamin B 12 deficiency in metformin-treated type 2 diabetes patients was 9.5% (n = 76), and the mean vitamin B 12 level was 662.5 246.7 pg/mL. Highlight selected keywords in the article text. How much vitamin B12 should a diabetic take? In the US, it is currently believed that adults with type 2 diabetes that are over 50 should take 2.4 g of synthetic vitamin B12 daily either in supplement form or in fortified food. 2016;134:4739, 22. Ahmed M, Muntingh G, Rheeder P. Vitamin B12 deficiency in metformin-treated type-2 diabetes patients, prevalence and association with peripheral neuropathy BMC Pharmacol Toxicol. Bethesda, MD 20894, Web Policies Another serious thing that may happen to vitamin B12 deficient people is loss of smell and taste sensations. RESULTS Biochemical B 12 deficiency was present in 5.8% of those with diabetes using metformin compared with 2.4% of those not using metformin ( P = 0.0026) and 3.3% of those Unauthorized use of these marks is strictly prohibited. These symptoms are pain and numbness in the arms, legs, hands, and feet. Taking omeprazole (Prilosec), lansoprazole (Prevacid) or It presents with When taken at appropriate doses, vitamin B-12 supplements are generally considered safe. Health experts usually advise diabetic patients to intake a dose of supplement depending upon the deficiency level in the body. Mayo Clinic on Incontinence - Mayo Clinic Press, NEW The Essential Diabetes Book - Mayo Clinic Press, NEW Ending the Opioid Crisis - Mayo Clinic Press, FREE Mayo Clinic Diet Assessment - Mayo Clinic Press, Mayo Clinic Health Letter - FREE book - Mayo Clinic Press. A P value of < 0.05 was considered statistically significant. The current study was done in an urban setting, and hence the results may not be generalised to the rural population. 1 The prevalence of vitamin B12 deficiency in diabetes mellitus Vitamin B12 deficiency resulting from metformin use has been demonstrated in multiple studies. Among those who took metformin for at least 1 year, 9 had vitamin B12 level < 240 pg/ml Vitamin B12 affects the dynamics of autonomic nervous system and its deficits has been linked to cardiovascular autonomic neuropathy therefore, vitamin B12 deficiency was A linear regression model was used to evaluate variables that correlated with vitamin B12 levels and diabetic neuropathy. No potential conflict of interest was reported by the author(s). Pflipsen M, Oh R, Saguil A, Seehusen D, Seaquist D, Topolski R. The prevalence of vitamin B12 deficiency in patients with type 2 diabetes: A cross-sectional study J Am Board Fam Med. This vitamin is essential for the proper functioning of the body. Damio C, Rodrigues A, Pinheiro M, Cruz Filho R, Cardoso G, Taboada G, et al Prevalence of vitamin B12 deficiency in type 2 diabetic patients using metformin: A cross-sectional study Sao Paulo Med J. BMC Pharmacol Toxicol. 2013;36:S1166, 27. Make sure to take a regular intake of this vitamin for diabetes and treatment of other diseases. Unable to load your collection due to an error, Unable to load your delegates due to an error. Routine vitamin B12 screening may prevent irreversible nerve damage in type-2 diabetes Patients with type-2 diabetes, taking metformin, should have their vitamin B12 levels assessed more regularly to avoid irreversible nerve damage, according to a new study presented at the Society for Endocrinology annual conference in Glasgow. Data was collected from the medical records of four tertiary MoH hospitals in Riyadh, Saudi Arabia (King Salman Hospital, King Saud Medical City, Prince Mohammed Bin Abdul-Aziz Hospital and Imam Abdurrahman Alfaisal Hospital). Mayo Clinic does not endorse companies or products. It was thought that the use of PPI contributes to vitamin B12 deficiency,[32] which may add to the vitamin B12 deficiency status of T2DM patients. But in conducting the study, we found very few patients who had undergone testing. WebMetformin and Vitamin B12 Deficiency Diabetes Discoveries & Practice Blog Metformin and Vitamin B12 Deficiency April 25, 2018 0 Comments Research Advancements Medication In conclusion, the study demonstrated that vitamin B12 deficiency exists among diabetes patients attending Princess Marian Hospital diabetes clinic. By using metformin for a long period, the absorption of vitamin B12 will be reduced in your body. World Health Organization. With this condition, your body does not have enough healthy red blood cells, due to a lack (deficiency) of vitamin B; It is one of The first possible treatment option is to look at your diet. [3], Metformin has been one of the most widely used antidiabetic agents taken orally. HHS Vulnerability Disclosure, Help The mean age of these 16 patients was 53.8 14.26 (range of 3584 years old). Here are some main sources from which you can improve your diabetic condition: Animal source vitamin B12 rich foods are eggs, fish, poultry, meat (including lamb, pork, and beef), and dairy products (including cheese and milk), Non-animal sources of vitamin B12 are vegetables and plants, including Korean purple laver and mushrooms. Measurement of blood methylmalonic acid (MMA), a vitamin B12-associated metabolite, is a commonly used biomarker. Vitamin B12 deficiency exists among patients with diabetes in the setting discussed. Usual Adult Dose for B12 Nutritional Deficiency: 25 to 2000 mcg orally daily Usual Adult Dose for Schilling Test: 1000 mcg intramuscularly is the flushing dose Usual Pediatric Dose for B12 Nutritional Deficiency: 0.5 to 3 mcg daily There were 206 (56.7%) males and 157 (43.3%) females, and 337 (92.8%) were Saudis. It said: A paired t-test showed that in group A [the group given B12], patients with vitamin B12 When there is incomplete absorption of vitamin B12 from food, your body will be deficient. . Metformin associated B12 deficiency J Assoc Physicians India. 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). Well, vitamin B12 does not play a role in the management of blood glucose levels. We also inquired about the use of metformin, antacids, oral contraceptives and calcium supplements. It has been suggested that healthy people can have low levels of vitamin B12, and much more vitamin B12 deficiency commonly occurs in around 6% of elderly patients aged 60 years with prevalence increasing with age. Vitamin B12 deficiency is highly prevalent, especially in patients with diabetic neuropathy. Hallucinations. Disclaimer. [2] The prevalence of diabetes in Saudi Arabia alone has increased to reach 7 million cases. https://www.micromedexsolutions.com. Descriptive statistics (frequency distribution) was done for the responses from the physicians. The only way to recover from your condition of hyperhomocysteinemia is by taking a regular dose of vitamin B12, vitamin B6, and folic acid. Association of vitamin B12 deficiency and metformin use in patients with type 2 diabetes. health information, we will treat all of that information as protected health
2003;(4):CD004514. Background: Type 2 diabetes mellitus is associated with vitamin B12 deficiency which is further increased in patients who are on metformin therapy. To learn about our use of cookies and how you can manage your cookie settings, please see our Cookie Policy. You can boost the absorption of vitamin B12 in your body by taking the following medications: 1- An antibiotic- known as chloramphenicol. Authors: News Author: Laurie Barclay, MD CME Author: Hien T. Nghiem, MD Log In to Start In this study an inverse correlation was found between diabetic neuropathy and the plasma level of vitamin B12. 2011;57:469, 11. de Groot-Kamphuis DM, van Dijk PR, Groenier KH, Houweling ST, Bilo HJ, Kleefstra N. Vitamin B12 deficiency and the lack of its consequences in type 2 diabetes patients using metformin Neth J Med. 2021 Oct 18;2021:8745968. doi: 10.1155/2021/8745968. Elsaier A, Elamami A, Zaid A. Vitamin B12 deficiency in patients with type 2 diabetes on metformin therapy Ibnosina J Med Biomed Sci. Aims To compare the prevalence of vitamin B12 deficiency and peripheral neuropathy between two groups of type 2 diabetes mellitus (T2DM) patients treated with or without metformin, and to determine factors associated with vitamin B12 deficiency therapy and dietary intake of vitamin B12. -Chronic treatment should be done with an oral preparation in patients with normal intestinal absorption. This outpatient cross-sectional study found 6.6% of patients with diabetes at Princess Marina Hospital diabetes clinic to be vitamin B12 deficient. Cyanocobalamin. [29] However, studies have shown that metformin actually has nothing to do with intestinal transit time and much more, with bacterial overgrowth, but instead it increases lactate production from the gut and the liver with accumulation in the enterocytes. Vitamin B12 is an essential vitamin, and deficiency generally occurs with inadequate absorption or lack of dietary intake. PMC Metformin is the base of medicine in the treatment of type 2 diabetes mellitus (T2DM) with estimates that it is frequently approved and recommended to 120 million patients with diabetes globally. Registered in England & Wales No. The use of vitamin B12 supplement was significant among patients who were 46 years old and above. This site needs JavaScript to work properly. 2. J Pak Med Assoc. You'll soon start receiving the latest Mayo Clinic health information you requested in your inbox. Type 2 Vitamin B12 deficiency and diabetic neuropathy are very high among metformin-treated T2DM patients and it is associated with increased GPA, IFA, TNF- and cardiometabolic risk factors (higher LDL and TC and lower HDL). This can happen if you don't eat In this study an inverse correlation was found between diabetic neuropathy and the plasma level of vitamin B12. We use cookies to improve your website experience. Delusions. You might be thinking about how you can take vitamin B12 naturally when you are a vegetarian. Vitamin deficiency anemia is a lack of healthy red blood cells caused by lower than usual amounts of vitamin B-12 and folate. FOIA The mean duration of T2DM was 10.27 7.99 years (range of 2.026.0 years) and the mean duration of metformin use was 10.27 7.99 years (range of 2.026.0 years). Problems concentrating. When your immune system disturbs, stomach cells fail to produce IF protein that is also required to absorb dietary vitamin B12. Not only are consuming vitamins and minerals healthy, but your body should also absorb them efficiently. Am J Clin Nutr. Instead of lowering blood glucose levels, the level of vitamin B12 gets lowered itself in diabetic patients. 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