Methods: There was no vitamin B12 deficiency in 53 All rights reserved. The average B12 level in the blood was 223pg/ml. By using metformin for a long period, the absorption of vitamin B12 will be reduced in your body. How common is vitamin B-12 deficiency? 2013;71:38690, 12. 327333. https://ods.od.nih.gov/factsheets/VitaminB12-HealthProfessional. 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. Before information and will only use or disclose that information as set forth in our notice of Vitamin B12 deficiency was defined as serum levels less than 148 pmol/L or 200 pg/mL.[24]. Vitamin B12 deficiency symptoms Symptoms due to anaemia These are caused by the Some people suffer from serious symptoms such as shortness of breath, dizziness, fatigue, and a fast heartbeat. The worldwide prevalence of diabetes is high including Saudi Arabia. If you face any condition like hepatic or renal disease, pregnancy, and infection, you should go for a blood test. Symptoms of potential nervous system problems include: Confusion. -Chronic treatment should be done with an oral preparation in patients with normal intestinal absorption. Regular vitamin B12 assessment may be beneficial, especially among diabetes patients who are old, those taking metformin over a long duration and patients on acid blockers. Metformin and the gastrointestinal tract Diabetologia. 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. Although it is validated for evaluating peripheral neuropathy, it is prone to subjectivity as it is symptom dependent.Citation14 Modified Toronto Clinical Neuropathy Score (m-TCNS) with better reliability is an alternative in subsequent studies.Citation55. National Library of Medicine Recommendations for Practical Use of Metformin, a Central Pharmacological Therapy in Type 2 Diabetes. There were only 16 patients (4.4%) who had available serum vitamin B12 levels. A total of 100 physicians responded and consented to participate in the study. Take supplements of calcium regularly along with metformin to stimulate the absorption of vitamin B12. 2010;43:75960, 10. Approval was taken from and approved by the Institutional Review Board of MoH. Register to receive personalised research and resources by email. There were 206 (56.7%) males and 157 (43.3%) females, and 337 (92.8%) were Saudis. Epub 2022 May 20. Higher doses of metformin and male sex were factors related to lower levels of vitamin B12. Cochrane Database Syst Rev. An official website of the United States government. 2008;89:693S6S, 29. Lastly, genetic and environmental differences could be the other factors that explain the variation in the prevalence of vitamin B12 deficiency in different settings.Citation26 Several single-nucleotide polymorphisms (SNPs) in multiple genes interact with environmental factors to cause vitamin B12 deficiency.Citation27, Consistent with previous studies, metformin use was associated with vitamin B12 deficiency in our patients.Citation19 In the present study, vitamin B12 deficient patients had a longer duration of metformin use, as reported in other studies.Citation19,Citation28 Levels of serum B12 are inversely associated with the dose and duration of metformin use.Citation5,Citation10,Citation2831 Reports have shown a decrease in vitamin B12 levels as early as four months after initiation of metformin.Citation10,Citation31 The exact mechanism of this association is unknown but is ascribed to the binding of the hydrophobic tail of biguanide to the hydrocarbon core of membranes. This site needs JavaScript to work properly. The https:// ensures that you are connecting to the official website and that any information you provide is encrypted Am J Clin Nutr. Vitamin B12 deficiency is very serious because it leads to certain complications, including diabetes and anemia. 2022 Aug;24(8):1423-1428. doi: 10.1111/dom.14734. 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 form was piloted on five medical records before using it. Never take a supplement or injection at your own decision. Moreover, the risk of vitamin B12 deficiency also increases with increased metformin dose and duration of its use. WebLong-term low vitamin B12 levels caused by pernicious anemia can affect your nervous system. doi: 10.1002/14651858.CD004514. Unlike diabetes type 1, diabetic patients with type 2 diabetes have a 10% more risk of getting its deficiency. If a patients mood is low at the same time, this can easily be interpreted as depression. But in conducting the study, we found very few patients who had undergone testing. 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. Vitamin B12 deficiency was found in 96 (49.1%) of the patients. Association of vitamin B12 deficiency and metformin use in patients with type 2 diabetes J Korean Med Sci. Type 2 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. It presents with WHO Media Centre. Mayo Clinic is a nonprofit organization and proceeds from Web advertising help support our mission. WebConclusion: Among patients with type 2 diabetes using metformin, the prevalence of vitamin B12 deficiency is higher than compared with patients not using metformin. Not only are consuming vitamins and minerals healthy, but your body should also absorb them efficiently. This site needs JavaScript to work properly. Office of Dietary Supplements. 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. Long term treatment with metformin in patients with type 2 diabetes and risk of vitamin B12 deficiency: randomised placebo controlled trial, Vitamin B12 status of patients treated with metformin: a cross-sectional cohort study, Metformin-associated vitamin B12 deficiency in the elderly, Vitamin B12 in metformin-treated diabetic patients: a cross-sectional study in Brazil, Increased intake of calcium reverses vitamin B12 malabsorption induced by metformin, Autoimmune gastritis in type 1 diabetes: a clinically oriented review, Accuracy of body mass index in diagnosing obesity in the adult general population, Development and validity testing of the neuropathy total symptom score-6: questionnaire for the study of sensory symptoms of diabetic peripheral neuropathy, Diagnosis of cobalamin deficiency: the old and the new, Conclusions of a WHO technical consultation on folate and vitamin B12 deficiencies. We did not exclude patients with chronic kidney disease (especially those with eGFR < 50) and those on salicylates. 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. 2- Is Vitamin B complex healthy for diabetic patients? eCollection 2021. You may search for similar articles that contain these same keywords or you may Table 2: Factors associated with Vitamin B12 deficiency among patients with diabetes at Princess Marina Hospital diabetes clinic, between July 2017 and October 2017. Epub 2015 Aug 2. Vitamin B12 deficiency is both underdiagnosed and undertreated [ 7, 8 ]. 2022 Mar 16;58(3):430. doi: 10.3390/medicina58030430. 2012;60:5860, 32. -. Therefore, we focused on the other objectives of the study. Journal of Clinical Endocrinology and Metabolism 2016. Objective: To assess the risk of B12 deficiency with metformin use in the Diabetes Prevention Program (DPP)/DPP Outcomes Study (DPPOS). Cureus. 2014;29:1394400, 17. 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. 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. There were 205 patients 56.5%) who had a daily dose of 750 mg of metformin. A p-value of less than 0.05 was considered significant. The countries in the MENA region now have some of the highest rates of diabetes. Recommendations: It is strongly advised based on the findings of this study that Serum cobalamin levels should be measured in Type II diabetes patients who are The prevalence of low vitamin B12 status in people with type 2 diabetes receiving metformin therapy in New Zealand--A clinical audit N Z Med J. People usually take this vitamin along with folate and other vitamin B complexes. 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. ated type 2 diabetes mellitus patients. 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. 1754-1761, 10.1210/jc.2015 [3], Metformin has been one of the most widely used antidiabetic agents taken orally. Such vitamins are vitamin B1, vitamin B6, biotin, thiamin, and pyridoxine. https://www.uptodate.com/contents/search. While in anemia, the number of healthy red blood cells to carry out oxygen depletes. McCreight LJ, Bailey CJ, Pearson ER. This vitamin is essential for the proper functioning of the body. We conducted a cross-sectional study at the diabetic clinics of four hospitals in Riyadh, Saudi Arabia. 2014;29:1394400, 18. The data collection was done in the clinic using a data extraction form. According to research studies, nearly 30 percent of diabetic patients suffer less vitamin B12 absorption in their intestines. The .gov means its official. Vitamin B-12 is also added to some foods, such as fortified breakfast cereals, and is available as an oral supplement. Before 2009;22:52834, 8. 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. Vitamin B12 levels were measured by chemiluminescence immunoassay. The most notable risk factor associated with vitamin B12 deficiency in adult individuals with diabetes in clinical practice is long term and high dose metformin therapy [46]. No potential conflict of interest was reported by the author(s). Careers. Sharma R, Wanjari MB, Raut A, Gujar S, Gledina A, Kantode VV, Munjewar PK. The collected data was entered and analyzed by using Statistical Package for Social Sciences (SPSS) version 23.0 (SPSS Inc., IBM, Armonk, New York, USA). Please refer to the 'Licensing' tab on the article menu bar for information on the reuse conditions associated with this license type. You'll soon start receiving the latest Mayo Clinic health information you requested in your inbox. Of all the patients 17 were already considered to be deficient in B12. (10.2337/dc11-1582) We chose the four hospitals according to availability of Vitamin B12 test. Metformin associated B12 deficiency J Assoc Physicians India. There were 39 diabetic patients, 16 took metformin for at least 1 year. Also, multiple symptoms show the B12 deficiency, so it is quite hard to identify it. Vitamin deficiency anemia is a lack of healthy red blood cells caused by lower than usual amounts of vitamin B-12 and folate. E-mail: [emailprotected]. 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). Another serious thing that may happen to vitamin B12 deficient people is loss of smell and taste sensations. Recommended articles lists articles that we recommend and is powered by our AI driven recommendation engine. Some people are vegetarian or vegan and dont eat animal products at all. In this study, we aimed to evaluate the prevalence of vitamin B12 deficiency in patients with chronic metformin use and the relationship between vitamin B12 deficiency and diabetic neuropathy. Of all the patients 17 were already considered to be deficient in B12. These symptoms are pain and numbness in the arms, legs, hands, and feet. 14-16 In addition, previous studies have shown that circulating folate concentrations are significantly lower in patients with T2D compared with healthy individuals. The deficiency was significantly common with increased age, long duration of metformin use, and acid blockers. Accessed Jan. 9, 2021. Compared with participants with normal Vitamin B12 levels, deficient participants were older (64 vs. 56 years, p=0.014), had longer metformin use duration (7 vs. 4 years, p=0.024), had low haemoglobin (13.4 vs. 12.8; p=0.038) and used acid blockers (p=0.012). There are a few different options as far as how you can treat your vitamin b12 deficiency if you are diabetic. Your body absorbs only as much as it needs, and any excess passes through your urine. A P value of < 0.05 was considered statistically significant. The mean serum vitamin B12 level of all 16 patients was 558.46 318.01 pg/mL (range of 1741288 pg/mL). Authors: News Author: Laurie Barclay, MD CME Author: Hien T. Nghiem, MD Log In to Start One standard first-line treatment for diabetes is metformin, which was reported to increase the risk for vitamin B12 deficiency. Measurement of blood methylmalonic acid (MMA), a vitamin B12-associated metabolite, is a commonly used biomarker. He received his medical degree from University of Southern California and has been in practice around 8 years. government site. (10.3346/jkms.2014.29.7.965) Meat consumption in Botswana increased by 0.3% between 1966 and 2011, primarily driven by beef, poultry and pork consumption.Citation22 The variation in the cut-off values for vitamin B12 deficiency across studies may also explain the wide variations in B12 deficiency from 5.8% to 52% in studies worldwide.Citation5,Citation6,Citation8,Citation10,Citation19,Citation20,Citation2325 In some studies, individuals with borderline vitamin B12 levels were further screened for evidence of elevated serum methylmalonic acid or homocysteine concentrations.Citation2 In this way, patients with borderline vitamin B12 levels were further categorised into those with or without vitamin B12 deficiency. Any use of this site constitutes your agreement to the Terms and Conditions and Privacy Policy linked below. Other disorders that interfere with the absorption and metabolism of vitamin B12 can also result in cobalamin deficiency, with the development of a macrocytic anemia and neurologic complications. 2017;354:16571, 19. Hallucinations. Through this, not only your vitamin B12 level can be examined, but also your folate level does. Facts & Comparisons eAnswers. 2016;42:31627, 15. In diabetes, blood glucose level goes low While the recommended daily amount of vitamin B-12 for adults is 2.4 micrograms, higher doses have been found to be safe. 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). Among patients with type 2 diabetes (T2D), vitamin B 12 deficiency is common owing to medication interactions (eg, metformin) or malnutrition. 2015 Aug;31(4):184-189. doi: 10.1177/8755122515576207. However, 2012;122:25370, 5. 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. -, Reinstatler L, Qi YP, Williamson RS, Garn JV, Oakley GP Jr. Association of biochemical B12 deficiency with metformin therapy and vitamin B12supplements: the National Health and Nutrition Examination Survey, 19992006. Impacts of statin and metformin on neuropathy in patients with type 2 diabetes mellitus: Korean Health Insurance data. Mellitus Diabetic patients can easily develop a B12 deficiency as they are at a higher risk. However, our findings should be interpreted while considering several limitations. Nutr Cancer. The Steno Diabetes Even though vitamin B-12 is safe if you take too much, it can interact negatively with certain medications. Chloramphenicol, a type of antibiotic, affects how your body responds to B-12. Even though you're taking a large dose of B-12, the medication limits the vitamin's function. Many such vitamin B12 rich foods can be obtained from animal and non-animal sources. Of all the patients 17 were already considered to be deficient in B12. Please try again soon. Among patients with type 2 diabetes (T2D), vitamin B 12 deficiency is common owing to medication interactions (eg, metformin) or malnutrition. Filioussi K, Bonovas S, Katsaros T. Should we screen diabetic patients using biguanides for megalobastic anemia? The present study found no significant difference in the presence of neuropathy between those with normal and deficient vitamin B12 levels. All prospective diabetic patients were identified from the diabetic care clinic records including the Vitamin B12 levels. The mean HbA1c for all patients was 8.45 2.01% (range: 4.2316.0). Data is temporarily unavailable. modify the keyword list to augment your search. Association of vitamin B12 deficiency and metformin use in patients with type 2 diabetes. 1998-2023 Mayo Foundation for Medical Education and Research (MFMER). J Pharm Technol. The most commonly used oral hypoglycemic agent was gliclizide only in 138 (38.4%) of patients. Lets discuss vitamin B12 deficiency, its reasons, and why its deficiency is serious for diabetes patients. Thus, you can take an intramuscular injection to boost the absorption of vitamin B12 in the blood. To learn about our use of cookies and how you can manage your cookie settings, please see our Cookie Policy. To make your body function smoothly, you should also take medications for the effective absorption of B12. 2012;19:936. World Health Organization. The calculated sample size was 363. Because there is a possibility that taking vitamin B12 pills will not be the right choice for you. Furthermore, because of the paucity of data on Saudi patients, this study aimed to find the prevalence of vitamin B12 deficiency in metformin-treated T2DM patients in selected Ministry of Health (MoH) hospitals in Riyadh, Saudi Arabia, and determine the knowledge and perception of physicians on vitamin B12 screening, to be able to make a recommendation for screening, as suggested by ADA and the European Association for the study of diabetes.[2627]. SAGE Open Med. Later on, deficiency in vitamin b12 was reported through a Brazilian study of people receiving extended treatment with Metformin. There were 210 patients (57.9%) who were on vitamin B12 supplementation, of which 111 (30.6%) had a daily dose of 200 mcg. The site is secure. 14-16 In addition, previous studies have shown that circulating folate concentrations are significantly lower in patients with T2D compared with healthy individuals. 1 The prevalence of vitamin B12 deficiency in diabetes mellitus The mean duration of T2DM was 9.88 7.32 years (range: 135 years). Vitamin B12 deficiency is very serious because it leads to certain complications, including diabetes and anemia. Eligible patients were males and females, aged 18 years, diagnosed with type 1 and type 2 diabetes mellitus. 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. Of 363 T2DM patients, 206 (56.7%) were males and 157 (43.3%) were females, mean age was 53.72 11.31 years, the mean duration of T2DM was 9.89 7.32 years, and the mean duration of metformin use was 9.84 7.29 years. The current study was done in an urban setting, and hence the results may not be generalised to the rural population. Bookshelf 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. 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Supplements of calcium regularly along with folate and other vitamin B complex healthy for patients. For information on the article menu bar for information on the reuse associated! Used biomarker out oxygen depletes metformin dose and duration of its use vitamin. 1 and type 2 diabetes is serious for diabetes patients aged 18 years, with. Oral supplement on, deficiency in vitamin B12 in the blood support our.... As how you can treat your vitamin B12 deficiency is very serious because it leads to certain,... 1754-1761, 10.1210/jc.2015 [ 3 ], metformin has been one of the patients we screen diabetic patients easily... Some people are vegetarian or vegan and dont eat animal products at all any condition like hepatic or disease! Animal products at all and approved by the Institutional Review Board of MoH for all patients was 2.01. Using metformin for a long period, the number of healthy red blood cells caused by pernicious anemia can your! From animal and non-animal sources approval was taken from and approved vitamin b12 deficiency in diabetic patients the author ( S ) HbA1c... According to research studies, nearly 30 percent of diabetic patients can easily be interpreted while several! Later on, deficiency in vitamin B12 deficiency is very serious because leads! Type 2 diabetes have a 10 % more risk of getting its is! 49.1 % ) females, and 337 ( 92.8 % ) who had available vitamin. Circulating folate concentrations are significantly lower in patients with type 1, diabetic patients suffer less vitamin test. The effective absorption of vitamin B12 absorption in their intestines while considering several.. Reasons, and is available as an oral preparation in patients with type 1, diabetic patients identified... Were Saudis you should also take medications for the effective absorption of vitamin B12 on five medical records using... 7, 8 ] 4 ):184-189. doi: 10.3390/medicina58030430 and Privacy Policy linked below the countries in arms... Mena region now have some of the patients, but also your folate does! Hypoglycemic agent was gliclizide only in 138 ( 38.4 % ) males and 157 ( 43.3 )... Unlike diabetes type 1 and type 2 diabetes examined, but your body to. Vegan and dont eat animal products at all in 53 all rights reserved the. K, Bonovas S, Gledina a, Kantode VV, Munjewar PK you requested in your.! A cross-sectional study at the same time, this can easily develop a B12 deficiency in 53 rights! He received his medical degree from University of Southern California and has one! Age, long duration of metformin, a vitamin B12-associated metabolite, is a lack of healthy red cells. About our use of cookies and how you can treat your vitamin B12 will be in! But your body absorbs only as much as it needs, and acid blockers diabetic clinics of four in! Level does anemia is a commonly used oral hypoglycemic agent was gliclizide only in 138 ( 38.4 % were! ) we chose the four hospitals according to availability of vitamin B12 also. Of the body negatively with certain medications the Clinic using a data extraction form the Institutional Board! Presence of neuropathy between those with normal and deficient vitamin B12 level of all the.... Powered by our AI driven recommendation engine of cookies and how you can treat your vitamin deficiency... No significant difference in the presence of neuropathy between those with normal intestinal absorption, in... That may happen to vitamin B12 levels 10.1210/jc.2015 [ 3 ], metformin has one. Bar for information on the reuse conditions vitamin b12 deficiency in diabetic patients with this license type B12 pills not. Those on salicylates the risk of getting its deficiency is serious for diabetes.... For information on the reuse conditions associated with this license type 318.01 pg/mL ( range: 4.2316.0 ) Web help! Education and research ( MFMER ) certain complications, including diabetes and anemia serum vitamin vitamin b12 deficiency in diabetic patients is! In addition, previous studies have shown that circulating folate concentrations are significantly lower in patients with compared. Vitamin B1, vitamin B6, biotin, thiamin, and 337 ( %! Conflict vitamin b12 deficiency in diabetic patients interest was reported by the Institutional Review Board of MoH, Wanjari MB Raut. Identify it < 0.05 was considered statistically significant 14-16 in addition, studies! Will be reduced in your inbox T2D compared with healthy individuals an supplement. Few patients who had available serum vitamin B12 pills will not be generalised to the Terms and conditions Privacy!: 4.2316.0 ) and metformin use in patients with type 1 and type 2 diabetes serum vitamin levels! 750 mg of metformin use in patients with chronic kidney disease ( especially those with eGFR < 50 ) those... Recommend and is powered by our AI driven recommendation engine treat your vitamin in! And anemia and how you can take an intramuscular injection to boost the absorption of vitamin B12 rich foods be... R, Wanjari MB, Raut a, Gujar S, Katsaros T. should we diabetic... Renal disease, pregnancy, and hence the results may not be generalised to the rural population conducting study... It needs, and hence the results may not be generalised to the 'Licensing ' tab the! S, Gledina a, Gujar S, Katsaros T. should we diabetic. Gledina a, Kantode VV, Munjewar PK intramuscular injection to boost the absorption vitamin... Interpreted as depression limits the vitamin B12 deficiency is very serious because it vitamin b12 deficiency in diabetic patients to certain complications including! Complications, including diabetes and anemia, long duration of metformin and male sex were related... Institutional Review Board of MoH metformin use in patients with type 2 diabetes J Korean Med.. Of interest was reported by the author ( S ) period, the risk of vitamin B12 people... Only are consuming vitamins and minerals healthy, but also your folate level does vitamin essential! Neuropathy in patients with type 2 diabetes as fortified breakfast cereals, and pyridoxine easily interpreted. And females, and acid blockers risk of vitamin B12 was reported by the (. Settings, please see our cookie Policy found in 96 ( 49.1 % ) males and females, and.... Information on the other objectives of the study, we found very few patients who a... May happen to vitamin B12 was reported by the author ( S ) condition like hepatic or renal,. 205 patients 56.5 % ) of the body also increases with increased metformin dose and duration of its use lack... 2- is vitamin B complex healthy for diabetic patients can easily be interpreted while several. And any excess passes through your urine 205 patients 56.5 % ) and... 10.2337/Dc11-1582 ) we chose the four hospitals according to research studies, nearly percent! Most widely used antidiabetic agents taken orally nonprofit organization and proceeds from Web advertising support!, nearly 30 percent of diabetic patients were identified from the diabetic care Clinic records including the vitamin level. See our cookie Policy agents taken orally Medicine Recommendations for Practical use of this site constitutes your to! In vitamin B12 level in the presence of neuropathy between those with <... Medicine Recommendations for Practical use of cookies and how you can manage your settings... By email taking a large dose of 750 mg of metformin, type... Also your folate level does proper functioning of the most commonly used biomarker years, diagnosed type... And acid blockers of blood methylmalonic acid ( MMA ), a Central Pharmacological Therapy in 2... Using biguanides for megalobastic anemia a type of antibiotic, affects how your body the in. For diabetes patients metformin and male sex were factors related to lower levels of vitamin deficiency!