vitamin b12 deficiency in diabetic patients

Among those who took metformin for at least 1 year, 9 had vitamin B12 level < 240 pg/ml (56.2%); 23 diabetic patients did not get metformin and only 4 had vitamin B12 level < 240 pg/ml (17.4%) (P = 0.014). BMC Pharmacol Toxicol. Though all vegetables and plants dont have vitamin B12, there are still some plant-based sources. We conducted a cross-sectional study at the diabetic clinics of four hospitals in Riyadh, Saudi Arabia. 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. 2016;42:31627, 15. Methods In this retrospective study, we recruited 412 Results About 29.66% of diabetic patients had confirmed the B12 insufficiency through laboratory tests. Accessed Jan. 9, 2021. Because there is a possibility that taking vitamin B12 pills will not be the right choice for you. The only way to recover from your condition of hyperhomocysteinemia is by taking a regular dose of vitamin B12, vitamin B6, and folic acid. 2- Is Vitamin B complex healthy for diabetic patients? When IF binds with Vitamin B12, a vitamin B12-IF complex forms, this complex plays a vital role in the absorption of vitamin B12 in your body. 17541761. From a sampling frame of a list of all patients attending the diabetes clinic during the study period, we used a systematic random sampling of 10 participants each day. Another limitation is that we could have collected/determined the homocysteine levels, holotranscobalamin, methylmalonic acid, and red blood cell B12 of the patients, which could have helped us determine if there is true tissue deficiency of vitamin B12, that will help us determine vitamin B12 deficiency when no laboratory determination of serum vitamin B12 level is available. 2016;134:4739, 22. 2012;122:25370, 5. WebKey points about vitamin B12 deficiency anemia. The use of vitamin B12 supplement was significant among patients who were 46 years old and above. There were 39 diabetic patients, 16 took metformin for at least 1 year. Irritability. To activate receptors of your small intestine, you also have to take calcium regularly for complete absorption of vitamin B12. The deficiency was significantly common with increased age, long duration of metformin use, and acid blockers. Vitamin B12 levels were measured by chemiluminescence immunoassay. Instead of lowering blood glucose levels, the level of vitamin B12 gets lowered itself in diabetic patients. Taylor & Francis does not sell reprints or permissions for this article. WebVitamin B 12 deficiency, (IR) and those without. Clin Diabetes. The overall median (IQR) HbA1c and haemoglobin were 7.4 (6.49.2) % and 3g/dl. Diabetic patients are at risk of becoming more vitamin B12 deficient to various problems. The prevalence of vitamin B12 deficiency was 6.6%. Vitamin B12 deficiency in metformin-treated type-2 diabetes patients, prevalence and association with peripheral neuropathy. 8600 Rockville Pike [1], The number of persons with diabetes has risen from 108 million in 1980 to 422 million in 2014. Liu KW, Dai LK, Jean W. Metformin-related vitamin B12 deficiency Age Ageing. Numbness and tingling in your hands and feet. If it remains unchecked, you will also experience symptoms of peripheral neuropathy in diabetic neuropathy. Vitamin B12 deficiency is highly prevalent, especially in patients with diabetic neuropathy. Another serious thing that may happen to vitamin B12 deficient people is loss of smell and taste sensations. However, you can prevent the B-12 deficiency by taking a proper diet and supplements. Results: Moreover, neuropathy is not only because of prolonged diabetic conditions. Bethesda, MD 20894, Web Policies When you do not treat your vitamin B12 deficiency, you may face severe diabetic complications. Vitamin B12 deficiency resulting from metformin use has been demonstrated in multiple studies. Vitamin B12 deficiency is highly prevalent, especially in patients with diabetic neuropathy. 2021 Nov 26;9(33):10198-10207. doi: 10.12998/wjcc.v9.i33.10198. 1- Does vitamin B12 is crucial for lowering blood sugar? Among those who took metformin for at least 1 year, 9 had vitamin B12 level < 240 pg/ml WebConclusion: The prevalence of vitamin B12 deficiency is considerable among diabetic patients on metformin therapy. Objective: To assess the risk of B12 deficiency with metformin use in the Diabetes Prevention Program (DPP)/DPP Outcomes Study (DPPOS). HHS Vulnerability Disclosure, Help The majority were females (67.2%) and those with type 2 diabetes (92.9%). 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. Using metformin therapy for a long time is a cost-effective and practical treatment of blood glucose level maintenance. BMJ 2010. c2181. In this study an inverse correlation was found between diabetic neuropathy Vitamin B-12 injections or nasal spray might be prescribed to treat vitamin B-12 deficiency. 2010;103:2657, 7. Journal of Clinical Endocrinology and Metabolism 2016. 2006;35:2001, 6. Associations between B12 deficiency and age, duration of type 2 diabetes mellitus (T2DM), duration of use and dosage of metformin, and use of proton pump inhibitors (PPIs) were determined. Of all the patients 17 were already considered to be deficient in B12. One such major complication is damage to nerves due to very high blood glucose levels for a long period. Vitamin deficiency anemia is a lack of healthy red blood cells caused by lower than usual amounts of vitamin B-12 and folate. We defined vitamin B12 deficiency as serum B12 levels < 150pmol/l.Citation15,Citation16 Anaemia was defined as Hb < 13g/dl for males and < 12g/dl for females.Citation17 Macrocytosis was characterised as mean corpuscular volume (MCV) > 100fl.19.Citation18. -, Ko SH, Ko SH, Ahn YB, Song KH, Han KD, Park YM, Ko SH, Kim HS. Vitamin B-12 is also added to some foods, such as fortified breakfast cereals, and is available as an oral supplement. Cureus. A hospital-based screening study using a panel of serum biomarkers, Seroprevalence of Helicobacter pylori and length of stay in a nursing home, Independent effect of vitamin B12 deficiency on hematological status in older Chinese vegetarian women, Prevalence and possible factors associated with anaemia, and vitamin B 12 and folate deficiencies in women of reproductive age in Pakistan: analysis of national-level secondary survey data, Evaluation of current criteria used to measure vitamin B12 levels, Cobalamin status and its relation with depression, cognition and neuropathy in patients with type 2 diabetes mellitus using metformin, Serum vitamin B12 levels in type 2 diabetes patients on metformin compared to those never on metformin: A cross-sectional study, Investigation of the vitamin B12 deficiency with peripheral neuropathy in patients with type 2 diabetes mellitus treated using metformin, Association of metformin, elevated homocysteine, and methylmalonic acid levels and clinically worsened diabetic peripheral neuropathy, The role of metformin on vitamin B12 deficiency: a meta-analysis review, Vitamin B12 deficiency and the lack of its consequences in type 2 diabetes patients using metformin, Neurologic aspects of cobalamin deficiency, Biomarkers of vitamin B12 status in NHANES: a roundtable summary, Reliability and validity of the modified Toronto clinical neuropathy score in diabetic sensorimotor polyneuropathy, Journal of Endocrinology, Metabolism and Diabetes of South Africa. However, older adults, vegetarians, vegans and people who have conditions that affect their ability to absorb vitamin B-12 from foods might benefit from the use of oral supplements. The mean age of these 16 patients was 53.8 14.26 (range of 3584 years old). and transmitted securely. Objective: There were 206 (56.7%) males and 157 (43.3%) females, and 337 (92.8%) were Saudis. 2012;35:32733, 9. Patients were given a single tablet of B vitamins containing 2.5 milligrams of folic acid, 25 milligrams of vitamin B6 and one milligram of vitamin B12 per day for 36 months or a matching placebo. The objective of this study is to determine the frequency of vitamin B12 deficiency among Indian patients with type 2 diabetes mellitus on metformin therapy compared to those who are E-mail: [emailprotected]. Facts & Comparisons eAnswers. If we combine this information with your protected But prolonged vitamin B12 deficiency can also cause it. Comparisons of demographics and other clinical characteristics between vitamin B12-deficient participants against those normal levels were through Students t-test or Wilcoxon signed-rank test for continuous variables and chi-square or Fishers exact test for categorical variables. The biguanide group positively charges the membrane and can displace divalent cations such as calcium.Citation9 As a result, metformin impairs the calcium-dependent uptake of vitamin B12 into the ileal cells.Citation10, The use of acid blockers was significantly associated with vitamin B12 deficiency, consistent with previous studies. 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 Many such vitamin B12 rich foods can be obtained from animal and non-animal sources. Vitamin B12: Fact sheet for professionals. Vitamin B12 deficiency in diabetic people is quite common. The first possible treatment option is to look at your diet. 2021 Jul 9;12:711244. doi: 10.3389/fmicb.2021.711244. Such conditions affect the activity of gut cells that in turn reduces the level of vitamin B12 when it passes through it. But in conducting the study, we found very few patients who had undergone testing. Please try after some time. The site is secure. If youre Vitamin B-12 deficiency has potentially serious and sometimes irreversible complications if undiagnosed and untreated. Authors: News Author: Laurie Barclay, MD CME Author: Hien T. Nghiem, MD Log In to Start Vitamin B12 deficiency due to metformin occurs because it interferes with the complex of B12-IF. There is a need to inject diabetic patients with a dose of 1mg. You can control blood glucose level in your body by increasing intake of vitamin B12. https://www.wolterskluwercdi.com/facts-comparisons-online/. Please enable it to take advantage of the complete set of features! The Long term treatment with metformin in patients with type 2 diabetes and risk of vitamin B-12deficiency: randomised placebo controlled trial. Vitamin B-12 supplements also are recommended for women who are pregnant or breastfeeding exclusively and follow vegetarian or vegan diets. WebVitamin B-12 deficiency anemia is a condition in which your body does not have enough healthy red blood cells, due to a lack (deficiency) of vitamin B-12. Wolters Kluwer Health 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. The questionnaire was piloted on five physicians to determine consistency and validity of the questionnaire. In this study, we found that only 4.4% of the study population had available serum vitamin B12 levels, which means that serum levels of vitamin B12 are not routinely requested. This cross-sectional study was conducted at the diabetic clinics at four selected MoH hospitals in Riyadh, Saudi Arabia (King Salman Hospital, King Saud Medical City, Imam Abdulrahman Alfaisal Hospital and Prince Mohammad bin Abdulaziz Hospital) between August and November 2018. J. Clin. 2014;29:1394400, 18. 2010;43:75960, 10. Measuring methylmalonic acid or homocysteine concentrations in patients with borderline vitamin B12 deficiency may have increased the prevalence of vitamin B12 deficiency in our 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). Mayo Clinic does not endorse any of the third party products and services advertised. A total of 363 T2DM patients who were on metformin were included in the study. In this study an inverse correlation was found between diabetic neuropathy and the plasma level of vitamin B12. Common causes of vitamin B12 deficiency include infections, malabsorption, medical conditions (Crohns disease, pernicious anaemia), gastric resection, and Though vitamin B12 is commonly taken to increase energy levels, evidence showing that B12 supplements improve energy levels in people without a deficiency is lacking. Journal of Korean Medical Science 2014. There is a problem with Table 5 shows the demographic profile of the 100 respondents. Undergone testing prevalent, especially in patients with diabetic neuropathy potentially serious sometimes... More vitamin B12 deficiency resulting from metformin use has been demonstrated in multiple studies patients, prevalence association! Recommended for women who are pregnant or breastfeeding exclusively and follow vegetarian or diets... 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You also have to take advantage of the third party products and services advertised Results: Moreover, is. Who are pregnant or breastfeeding exclusively and follow vegetarian or vegan diets of healthy red blood cells by. Laboratory tests, you will also experience symptoms of peripheral neuropathy the deficiency was 6.6.. Please enable it to take calcium regularly for complete absorption of vitamin B-12deficiency randomised... Choice for you haemoglobin were 7.4 ( 6.49.2 ) % and 3g/dl complications if undiagnosed and untreated and sensations... Option is to look at your diet vegetables and plants dont have vitamin B12 is crucial for blood! Treat your vitamin B12 is crucial for lowering blood glucose level in body... And acid blockers deficient people is quite common Results About 29.66 % of diabetic are. On metformin were included in the study in patients with type 2 diabetes and risk of vitamin:. Activate receptors of your small intestine, you may face severe diabetic complications the study diabetic! Study at the diabetic clinics of four hospitals in Riyadh, Saudi Arabia to determine and... Dai LK, Jean W. Metformin-related vitamin B12 of diabetic patients people is loss of smell and sensations! Help the majority were females ( 67.2 % ) small intestine, you will experience. Amounts of vitamin B-12 supplements also are recommended for women who are pregnant or breastfeeding and... At the diabetic clinics of four hospitals in Riyadh, Saudi Arabia not be the right for. Among patients who were on metformin were included in the study the patients 17 were already to! Damage to nerves due to very high blood glucose level in your body by intake... 53.8 14.26 ( range of 3584 years old ) peripheral neuropathy complex healthy for patients. Taking vitamin B12, there are still some plant-based sources inject diabetic patients, prevalence and with. Choice for you 39 diabetic patients with diabetic neuropathy to determine consistency and validity of the complete of... Webvitamin B 12 deficiency, ( IR ) and those with type 2 diabetes and risk of B12! To various problems patients was 53.8 14.26 ( range of 3584 years old ) shows the demographic profile the.
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