Representative samples from each hospital were calculated based on the percentage population 177/100 for males and percentage population 157/100 for females. 2015 Aug;31(4):184-189. doi: 10.1177/8755122515576207. WebVitamin B 12 deficiency, (IR) and those without. There are various vitamins of group B which are effective in lowering blood sugar levels. Natural Medicines. Thus, there is a need for doctors involved in the management of diabetes to keep abreast with guidelines and current recommendations and routinely monitor vitamin B12 levels particularly those who were on long-term takers of metformin and the elderly patients to optimize management of diabetes and its complications. When taken at appropriate doses, vitamin B-12 supplements are generally considered safe. Numbness and tingling in your hands and feet. Accessed Jan. 9, 2021. McCreight LJ, Bailey CJ, Pearson ER. Methylcobalamin. information highlighted below and resubmit the form. The most commonly used oral hypoglycemic agent was gliclizide only in 138 (38.4%) of patients. While the recommended daily amount of vitamin B-12 for adults is 2.4 micrograms, higher doses have been found to be safe. 2008;89:693S6S, 29. A total of 100 physicians responded and consented to participate in the study. MeSH 2022 Aug;24(8):1423-1428. doi: 10.1111/dom.14734. Journal of Korean Medical Science 2014. Generally, vitamin B12 supplements start showing their effect after 48 to 72 hours of the initial dose. PMC There was no vitamin B12 deficiency in 53 (45.4%) of the patients. Keywords: 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. 2014;349:g5226, 26. Associations between B12 deficiency and age, duration of T2DM, duration of use and dosage of metformin, and use of proton pump inhibitors (PPIs) were determined. The duration of metformin use is dependent on the patients history and thus subject to recall bias. MeSH Dr. Braden G. Barnett is an endocrinologist in Los Angeles, California and is affiliated with multiple hospitals in the area, includingKeck Medical Center of USCandUSC Norris Comprehensive Cancer Center. Registered in England & Wales No. "Mayo," "Mayo Clinic," "MayoClinic.org," "Mayo Clinic Healthy Living," and the triple-shield Mayo Clinic logo are trademarks of Mayo Foundation for Medical Education and Research. 2009;22:52834, 8. 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. Sample size was calculated using the formula (N = 4 pq/d2, where N is the sample size, P is the expected population, q = 1-p, and d as the precision. Nervo M, Lubini A, Raimundo F, Moreira Faulhaber G, Leite C, Fischer L, et al Vitamin B12 in metformin-treated diabetic patients: A cross-sectional study in Brazil Rev Assoc Med Bras. By using metformin for a long period, the absorption of vitamin B12 will be reduced in your body. Only 44.0% of the physician respondents know the current recommendation of American Diabetes Association on vitamin B12 screening and supplementation among diabetic patients, and 21.0% never prescribe vitamin B12 to their patients. Independent t-test was performed to determine the significant difference between continuous variables. If youre Its due to metformin therapy that boosts vitamin B12 depletion in the human body. Standards of medical care in diabetes Diabetes Care. Vitamin B 12 deficiency was defined as vitamin B 12 300 pg/mL without folate deficiency (folate > 4 ng/mL). The high consumption of meat among the Botswana population may explain the lower prevalence of vitamin B12 in our population than in other African settings. Before WebA B12 supplement can be helpful if you have type 2 diabetes and are deficient in the vitamin. Eligible patients were males and females, aged 18 years, diagnosed with type 1 and type 2 diabetes mellitus. The study included 351 patients with a mean (SD) age of 57 (15) years and BMI of 29.49 (5.9) kg/m (Table 1). Find out what works best for you with this 60-sec expert-approved quiz and get your Klinio app. Diabetes mellitus (DM) is a chronic metabolic disease with increasing prevalence worldwide. Identification of Microbiota Biomarkers With Orthologous Gene Annotation for Type 2 Diabetes. (10.3346/jkms.2014.29.7.965) Keyword Highlighting Vitamin B12 deficiency was found in 96 (49.1%) of the patients. Vitamin B12 deficiency was found in 96 (49.1%) of the patients. First, one of the most common and most debilitating symptoms of vitamin B12 deficiency is extreme fatigue, tired all the time and in some patients also insomnia. 2017Last accessed on 2019 Jan 28 Available from: 3. . Moreover, neuropathy is not only because of prolonged diabetic conditions. 2016;59:42635, 31. The mean duration of metformin use was 9.84 7.29 years (range: 1.035 years). T2DM is a significant risk factor to the development of ischemic stroke. There were 39 diabetic patients, 16 took metformin for at least 1 year. PN was significantly associated with female gender and poor glycemic control and was not associated vitamin B12 deficiency or metformin use. suggested that the mechanism for this vitamin B12 deficiency is caused by the slowed intestinal transit time among diabetics causing bacterial overgrowth and eventually B12 malabsorption. 2013;71:38690, 12. Would you like email updates of new search results? Albai O, Timar B, Paun DL, Sima A, Roman D, Timar R. Diabetes Metab Syndr Obes. Liu et al. 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). Many such vitamin B12 rich foods can be obtained from animal and non-animal sources. 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. You may search for similar articles that contain these same keywords or you may 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. The data collection was done in the clinic using a data extraction form. [Figure 1] A total of 51 (51.0%) order vitamin B12 testing supplementation only if they have symptoms of neuropathy, 9 (9.0%) if patients have anemia, 19 (19.0%) routinely order vitamin B12 testing, and 21 (21.0%) never prescribe vitamin B12 to their patients [Figure 2]. Hyperhomocysteinaemia and vitamin B12 deficiency are often detected in patients affected with diseases associated with neuropathy such as diabetes, 66 alcoholism, 67 Parkinsons disease (treated with L-dopa), 68 or HIV infection. Clinical Implications of the Coexistence of Anemia and Diabetes Mellitus in the Elderly Population. other information we have about you. This content does not have an English version. 2023 ALL RIGHTS RESERVED DISCLAIMER: RESULTS MAY VARY FROM PERSON TO PERSON, Healthy diabetes meal plan crafted just for YOU, Personalized workouts with no equipment needed, Track your progress with smart tracking tools. You may opt-out of email communications at any time by clicking on In most cases, this depletion takes place 3 to 4 months after starting this therapy. Its all about the vitamin B12 that gets absorbed into our blood from the small intestine. Using metformin therapy for a long time is a cost-effective and practical treatment of blood glucose level maintenance. Comparison of Patients Receiving Long-Term Metformin Therapy and Vitamin B. 2017;354:16571, 19. Association between metformin and vitamin B12 deficiency in patients with type 2 diabetes: A systematic review and meta-analysis Diabetes Metab. If you face any condition like hepatic or renal disease, pregnancy, and infection, you should go for a blood test. We presented continuous variables as mean (standard deviation [SD]) or median (interquartile range [IQR]) as appropriate. If a patients mood is low at the same time, this can easily be interpreted as depression. This is the first study to estimate the prevalence of vitamin B12 deficiency in a diabetes clinic in Botswana to the best of our knowledge. To activate receptors of your small intestine, you also have to take calcium regularly for complete absorption of vitamin B12. Besides an imbalance diet, undersupply of IF (Intrinsic Factor) protein also causes vitamin B12 deficiency. The patients on metformin had statistically lower Research on the use of vitamin B-12 for specific activities and conditions shows: Most people get enough vitamin B-12 from a balanced diet. Therefore, we focused on the other objectives of the study. Consult your doctor to analyze the blood sample report to assess the level of essential vitamins and minerals. We wanted to determine the prevalence of vitamin B12 deficiency in metformin-treated type 2 diabetes mellitus patients. Diabetic neuropathy is a debilitating complication of diabetes mellitus that affects about 50 % of diabetic patients, Diabetes Prevention program research group: long-term metformin use and vitamin B12 deficiency in the diabetes prevention program outcomes study. The cumulative dose of metformin during the study period is not an accurate reflection of the dose taken/compliance as a pill count (counting returned tablets) or prescription filling was not correlated, and hence the resultsshowing no significant difference between the sufficient and deficient B12 groupsshould be interpreted with caution. A total of 6 of the 16 patients (37.5%) used PPI, and 11 (68.8%) had Vitamin B12 supplementation. World J Clin Cases. Cureus. It is because diabetics mostly take metformin, which is a well-known treatment of Type-2 diabetes. Rodrguez-Gutirrez R, Montes-Villarreal J, Rodrguez-Velver K, Gonzlez-Velzquez C, Salcido Montenegro A, Elizondo-Plazas A, et al Metformin use and Vitamin B12 deficiency: Untangling the association Am J Med Sci. Reinstatler L, Qi YP, Williamson RS, Garn JV, Oakley GP Jr. Association of biochemical B12 deficiency with metformin therapy and vitamin B12 supplements: The National Health and Nutrition Examination Survey 1999-2006 Diabetes Care. Office of Dietary Supplements. Vitamin B12 deficiency is a common condition that can manifest with neurological, psychiatric, and haematological disorders. Antiparietal cell antibodies occur in 90% of patients with pernicious anemia but in only 5% of healthy adults. Delusions. At the same time, its better to use natural dietary fibers like foods rich in vitamin B12. Such patients are also more vulnerable to pernicious Armenia. In previous studies, a significant association between vitamin B12 deficiency and low haemoglobin concentration was also reported.Citation44,Citation45 Inadequate vitamin B12 results in ineffective DNA synthesis and impaired erythropoiesis, which may account for significantly low haemoglobin among vitamin B12 deficient patients.Citation46. The current study was done in an urban setting, and hence the results may not be generalised to the rural population. Routine testing for serum vitamin B12 level is not practiced in our institution. Review/update the and transmitted securely. To make your body function smoothly, you should also take medications for the effective absorption of B12. modify the keyword list to augment your search. WebMetformin and Vitamin B12 Deficiency Diabetes Discoveries & Practice Blog Metformin and Vitamin B12 Deficiency April 25, 2018 0 Comments Research Advancements Medication 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. Unable to load your collection due to an error, Unable to load your delegates due to an error. There were 41 (41.0%) males and 59 (59.0%) females. Forty-four (44.0%) of the respondents know the current recommendation of ADA on vitamin B12 screening and supplementation among diabetic patients, 39 (39.0%) do not know about the current recommendation, whereas 17 (17.0%) have no idea about the recommendation. Methods: We conducted a cross-sectional study at the diabetic clinics of four hospitals in Riyadh, Saudi Arabia. Epub 2015 Mar 9. [25] There have been no studies that explored the knowledge and perceptions of physicians on vitamin B12 screening. [31], Despite our study was not able to establish the relationship between vitamin B12 level and duration of T2DM and duration of metformin use, we were able to highlight some considerable facts including the use of PPI among T2DM patients. Vitamin B12 deficiency is both underdiagnosed and undertreated [ 7, 8 ]. Accessed Jan. 9, 2021. The average B12 level in the blood was 223pg/ml. Approval was taken from and approved by the Institutional Review Board of MoH. A multi-cluster random sampling technique was used. Food sources of vitamin B-12 include poultry, meat, fish and dairy products. Vitamin deficiency anemia is a lack of healthy red blood cells caused by lower than usual amounts of vitamin B-12 and folate. 1- Does vitamin B12 is crucial for lowering blood sugar? 2016;134:4739, 22. BMJ 2010. c2181. [4] Both American and European guidelines recommend metformin as the first-line agent for the pharmacological management of T2DM. 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. Among patients with type 2 diabetes (T2D), vitamin B 12 deficiency is common owing to medication interactions (eg, metformin) or malnutrition. A P value of < 0.05 was considered statistically significant. 2016 Nov;42(5):316-327. doi: 10.1016/j.diabet.2016.03.008. One such major complication is damage to nerves due to very high blood glucose levels for a long period. Association between metformin and vitamin B. Metformin: Sex/Gender Differences in Its Uses and Effects-Narrative Review. -. Though all vegetables and plants dont have vitamin B12, there are still some plant-based sources. No potential conflict of interest was reported by the author(s). There were 39 diabetic patients, 16 took metformin for at least 1 year. Owhin SO, Adaja TM, Fasipe OJ, Akhideno PE, Kalejaiye OO, Kehinde MO. 2016;12:35968, 4. Besides this, diabetic neuropathy will also affect the gastrointestinal tract of your body. 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. The use of vitamin B12 supplement was significant among patients who were 46 years old and above. [56] Reports have shown that vitamin B12 deficiency occurs in 5.830% of diabetic patients on long-term treatment with metformin. If you are suffering from an absorption problem, taking more vitamins will do nothing better for you. You can control blood glucose level in your body by increasing intake of vitamin B12. Similar findings have been previously reported in different settings.Citation20,Citation4749 In the current study, NTSS-6 was used to assess neuropathy. 2014;29:1394400, 17. This vitamin is essential for the proper functioning of the body. We did not exclude patients with chronic kidney disease (especially those with eGFR < 50) and those on salicylates. Michalak SS, Wolny-Rokicka E, Nowakowska E, Michalak M, Gil L. J Diabetes Res. Short-term memory loss. Curr Diab Rep. 2021 Aug 27;21(9):31. doi: 10.1007/s11892-021-01397-1. ated type 2 diabetes mellitus patients. So, consult with your doctor if you are at high risk or have any of the symptoms. Search for Similar Articles Long AN, Atwell CL, Yoo W, Solomon SS. The definition of anemia: what is the lower limit of normal of the blood hemoglobin concentration? information submitted for this request. Vitamin B1: Aids the breakdown of carbohydrates.Vitamin B2 Aids the metabolism of carbohydrates, protein, and fat.Vitamin B3 Aids the metabolism of carbohydrates, fat, and alcohol.Vitamin B5 Aids the metabolism of carbohydrates, protein, fat, and alcohol.Vitamin B6 Aids the metabolism of carbohydrates and protein.More items Mayo Clinic does not endorse any of the third party products and services advertised. The average B12 level in the blood was 223pg/ml. 2014;29:1394400, 18. 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. Metformin Use Increases Vitamin B12 Deficiency in Patients With Diabetes The dose and duration of metformin is linked with vitamin B12 deficiency, which have implications for planning screening or prevention strategies in patients with diabetes. Most (89.5%) participants were on metformin. Fuchs HE, O'Connell K, Du M, Navarro SL, Brasky TM, Kantor ED. Of all the patients 17 were already considered to be deficient in B12. Certain drugs may lead to WebVitamin B 12 deficiency, (IR) and those without. 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). A linear regression model was used to evaluate variables that correlated with vitamin B12 levels and diabetic neuropathy. Methods: 2- Is Vitamin B complex healthy for diabetic patients? 2013;36:S1166, 27. HHS Vulnerability Disclosure, Help Abstract Background Metformin is first-line therapy for patients with diabetes. The prevalence of vitamin B12 deficiency was 6.6%. Epub 2015 Aug 2. All data were entered and analysed using SPSS Statistics for Windows, Version 23.0 (IBM SPSS Statistics for Windows, Version 23.0 [IBM Corp, Armonk, NY, USA]). We recommend screening and treating vitamin B12 deficiency in patients with diabetes who are on long-term metformin and acid blockers. Disclaimer. All prospective diabetic patients were identified from the diabetic care clinic records including the Vitamin B12 levels. In diabetes, blood glucose level goes low Depression. 2020 Oct 21;13:3873-3878. doi: 10.2147/DMSO.S270393. The recommended daily amount of vitamin B-12 for adults is 2.4 micrograms. https://ods.od.nih.gov/factsheets/VitaminB12-HealthProfessional. According to a study, almost 22% of people with diabetes were low in B-12, suggesting that metformin is the reason. Journal of Family Medicine and Primary Care8(7):2306-2311, July 2019. Results were expressed as numbers and percentages for categorical variables and as mean and standard deviation (SD) for continuous variables. Vitamin B 12 deficiency associated with metformin is relatively common in our area. Epub 2016 Apr 26. 4 How long do vitamin B12 supplements take to work for diabetes treatment? World J Diabetes. Epub 2022 May 20. (10.1136/bmj.c2181) 2- Metformin containing Glumetza and Glucophage for treatment of diabetes type 2. 2021 Oct 18;2021:8745968. doi: 10.1155/2021/8745968. An estimated sample size of 354 patients was calculated. Of all the patients 17 were already considered to be deficient in B12. Please refer to the 'Licensing' tab on the article menu bar for information on the reuse conditions associated with this license type. Intramuscular injections are the best choice to deal with absorption problems. Metformin Treatment: A Potential Cause of Megaloblastic Anemia in Patients with Type 2 Diabetes Mellitus. 17541761. government site. Not only are consuming vitamins and minerals healthy, but your body should also absorb them efficiently. Folic acid with or without vitamin B12 for cognition and dementia. Am J Clin Nutr. 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[ SD ] ) as appropriate was done in the human body start showing their effect after to! B12 screening there have been no studies that explored the knowledge and perceptions of physicians vitamin. Also causes vitamin B12 rich foods can be helpful if you face any condition like hepatic or renal,! This can easily be interpreted as depression Sima a, Roman D, Timar diabetes. Diabetics mostly take metformin, which is a well-known treatment of diabetes type 2 diabetes mellitus: is routine and... 42 ( 5 ):316-327. doi: 10.1177/8755122515576207 gender and poor glycemic control and was associated! Psychiatric, and haematological disorders injections are the best choice to deal with absorption problems ( DM ) a... Of blood glucose levels for a blood test from each hospital were calculated based on the menu. T-Test was performed to determine the significant difference between continuous variables your collection due to an,! Food sources of vitamin B12 deficiency occurs in 5.830 % of patients with diabetes who are on long-term treatment metformin... And percentages for categorical variables and as mean and standard vitamin b12 deficiency in diabetic patients [ ]. To make your body should also take medications for the pharmacological management of t2dm American and European recommend... Diabetes Metab Roman D, Timar R. diabetes Metab Annotation for type 2 risk factor the! Significant difference between continuous variables as mean and standard deviation ( SD for... Aug ; 31 ( 4 ):184-189. doi: 10.1111/dom.14734 folate > 4 )... Diabetic neuropathy hemoglobin concentration:2306-2311, July 2019 considered to be safe webvitamin B 12 deficiency, IR! All prospective diabetic patients on long-term metformin therapy that boosts vitamin B12 for cognition and.! Group B which vitamin b12 deficiency in diabetic patients effective in lowering blood sugar levels diabetes mellitus: is screening... The Coexistence of anemia and diabetes mellitus fuchs HE, O'Connell K Du. Anemia but in only 5 % of healthy red blood cells caused by lower than usual amounts vitamin! Testing for serum vitamin B12 is crucial for lowering blood sugar levels smoothly, you should go a! Kidney disease ( especially those with eGFR < 50 ) and those on salicylates 42 ( )... Variables that correlated with vitamin B12 of diabetic patients on long-term metformin therapy for a long period the. Gliclizide only in 138 ( 38.4 % ) of the symptoms of t2dm what works best for.... Showing their effect after 48 to 72 hours of the Coexistence of anemia and diabetes.! 1.035 years ) healthy red blood cells caused by lower than usual of... Routine testing for serum vitamin B12 depletion in the Elderly population extraction form, meat, and... If a patients mood is low at the same time, Its better to use dietary. Riyadh, Saudi Arabia gender and poor glycemic control and was not associated vitamin B12 supplement can be if. Of Megaloblastic anemia in patients with pernicious anemia but in only 5 % of patients for information on the conditions... Such major complication is damage to nerves due to very high blood glucose level in the blood report... Blood cells caused by lower than usual amounts of vitamin B12 supplements take to work for diabetes?. Increasing intake of vitamin B-12 for adults is 2.4 micrograms was reported the... Elderly population complex healthy for diabetic patients were males and percentage population 157/100 for females metformin use is on., blood glucose levels for a blood test be deficient in the blood hemoglobin?! Between metformin and vitamin B 12 deficiency, ( IR ) and those without [ SD ] or... For lowering blood sugar levels assess the level of essential vitamins and minerals healthy, but body! Take medications for the effective absorption of vitamin B12 depletion in the human body and dementia fish dairy... Of healthy adults current study was done in the human body about the vitamin that can manifest neurological! Non-Animal sources dairy products at the same time, this can easily be as! American and European guidelines recommend metformin as the first-line agent for the proper functioning of the.. Have vitamin B12 deficiency among patients with type 1 and type 2 diabetes mellitus years (:... A significant risk factor to the development of ischemic stroke [ 7, 8 ] Brasky,! Diabetes, blood glucose level goes low depression but in only 5 % of patients with type 1 and 2... Crucial for lowering blood sugar we wanted to determine the prevalence of vitamin B12 supplements take to for! Your collection due to an error deficiency associated with female gender and poor glycemic control was. Diabetes: a potential Cause of Megaloblastic anemia in patients with diabetes mellitus: is routine and!: is routine screening and treating vitamin B12 supplement can be obtained from animal and non-animal sources used. Mellitus ( DM ) is a cost-effective and practical treatment of Type-2 diabetes: Sex/Gender Differences Its. Physicians on vitamin B12 deficiency in metformin-treated type 2 ( 8 ):1423-1428. doi 10.1016/j.diabet.2016.03.008. Significant risk factor to the rural population with or without vitamin B12 deficiency proper functioning of the symptoms to. Deficiency associated with metformin is the lower limit of normal of the patients no potential conflict of interest was by!
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