2021 Nov 26;9(33):10198-10207. doi: 10.12998/wjcc.v9.i33.10198. Moreover, the risk of vitamin B12 deficiency also increases with increased metformin dose and duration of its use. Further research is needed to confirm the need for routine 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. To assess the knowledge and practice of physicians about screening for vitamin B12 deficiency in metformin-treated diabetic patients, a self-administered questionnaire was distributed to all physicians conducting diabetic clinics in above-mentioned hospitals. The mean duration of T2DM was 9.88 7.32 years (range: 135 years). Taylor & Francis does not sell reprints or permissions for this article. Vitamin B-12 injections or nasal spray might be prescribed to treat vitamin B-12 deficiency. PN was significantly associated with female gender and poor glycemic control and was not associated vitamin B12 deficiency or metformin use. Besides an imbalance diet, undersupply of IF (Intrinsic Factor) protein also causes vitamin B12 deficiency. Besides this, diabetic neuropathy will also affect the gastrointestinal tract of your body. The use of vitamin B12 supplement, duration of T2DM and duration of metformin use was significantly higher among females. World J Clin Cases. Your body absorbs only as much as it needs, and any excess passes through your urine. You can control blood glucose level in your body by increasing intake of vitamin B12. Take supplements of calcium regularly along with metformin to stimulate the absorption of vitamin B12. There were 107 patients (29.5%) who were on PPIs. The best way to treat low-level of vitamin B12 is by excessive intake of fortified bread, cereals, eggs, and milk. PMC Diabetes: Fact sheet [Internet]. A large percentage of physicians are not aware of the current recommendations of the American Diabetic Association (ADA) regarding vitamin B12 supplementation and screening. Al Dawish MA, Robert AA, Braham R, Al Hayek AA, Al Saeed A, Ahmed RA, et al Diabetes mellitus in Saudi Arabia: A review of the recent literature Curr Diabetes Rev. People with diabetes type 1 are usually at higher risk of getting autoimmune disorders like thyroid problems and coeliac disease. Clipboard, Search History, and several other advanced features are temporarily unavailable. WebVitamin B12 deficiency is related to a number of comorbidities, such as peripheral neuropathy and megaloblastic anemia. Their mean daily dose of metformin was 828.13 150.52 mg (range of 5001000 mg). Epub 2015 Mar 9. According to research studies, nearly 30 percent of diabetic patients suffer less vitamin B12 absorption in their intestines. The form was piloted on five medical records before using it. Articles in Google Scholar by Amal N. Alshammari, Other articles in this journal by Amal N. Alshammari, Privacy Policy (Updated December 15, 2022). 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. 2016;59:42635, 30. [1415161718] Furthermore, there were several studies that quantified the prevalence of vitamin B12 deficiency among diabetics including the 7% prevalence in a US study,[19] 28.1% prevalence in a South African study,[20] 22.5% in Brazil,[21] 18.7% in New Zealand,[22] 9.7% in the Netherlands,[7] and 9.7% in Libya. Using metformin therapy for a long time is a cost-effective and practical treatment of blood glucose level maintenance. The mean daily dose of metformin was 984.85 320.96 mg (range: 5002000 mg). Unauthorized use of these marks is strictly prohibited. In short, the long-term deficiency of vitamin B12 causes serious symptoms like depression, delusion, difficulty in walking, loss of mobility, seizures, and dementia. the unsubscribe link in the e-mail. Sharma R, Wanjari MB, Raut A, Gujar S, Gledina A, Kantode VV, Munjewar PK. Natural Medicines. -Chronic treatment should be done with an oral preparation in patients with normal intestinal absorption. information is beneficial, we may combine your email and website usage information with 2016 Nov;42(5):316-327. doi: 10.1016/j.diabet.2016.03.008. https://www.uptodate.com/contents/search. Association between metformin and vitamin B12 deficiency in patients with type 2 diabetes: A systematic review and meta-analysis Diabetes Metab. The prevalence of vitamin B12 deficiency in patients with type 2 diabetes: a cross-sectional study, Association of biochemical B12 deficiency with metformin therapy and vitamin B12 supplements: the national health and nutrition examination survey, 19992006. Vitamin B12 affects the dynamics of autonomic nervous system and its deficits has been linked to cardiovascular autonomic neuropathy therefore, vitamin B12 deficiency was 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. (10.1210/jc.2015-3754) September 5, 2016. 2021 Jul 15;12(7):916-931. doi: 10.4239/wjd.v12.i7.916. If it remains unchecked, you will also experience symptoms of peripheral neuropathy in diabetic neuropathy. Impacts of statin and metformin on neuropathy in patients with type 2 diabetes mellitus: Korean Health Insurance data. Delusions. Lets read how type 1 and 2 diabetes affect the level of Vitamin B12 in your body. Metformin; type 2 diabetes; Vitamin B12 deficiency; Vitamin B12 screening; Vitamin B12 supplementation. 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 A multi-cluster random sampling technique was used. Moreover, neuropathy is not only because of prolonged diabetic conditions. McCreight LJ, Bailey CJ, Pearson ER. Of all the patients 17 were already considered to be deficient in B12. 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. Vitamin B12 deficiency due to metformin occurs because it interferes with the complex of B12-IF. Ko SH, Ahn YB, Song KH, Han KD, Park YM, Kim HS. "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. 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. WebVitamin B 12 deficiency, (IR) and those without. Also, add a good amount of green leafy vegetables to your diet. Owhin SO, Adaja TM, Fasipe OJ, Akhideno PE, Kalejaiye OO, Kehinde MO. 2006;35:2001, 6. The site is secure. Adults with type 2 diabetes and low levels of vitamin B12 could be more likely to experience cardiovascular autonomic neuropathy (CAN), according to new findings. A single copy of these materials may be reprinted for noncommercial personal use only. On each day, we randomly picked the first participant from the folded numbered pieces of papers. Irritability. information highlighted below and resubmit the form. Vitamin B-12 deficiency is not common in the U.S. Due to deficiency of B12 vitamin, the level of blood glucose decreases. Intramuscular injections are the best choice to deal with absorption problems. No potential conflict of interest was reported by the author(s). 2019 Aug;69(Suppl 3)(8):S40-S44. [28] Type 2 diabetics particularly those on metformin are at risk for metabolically lower levels of vitamin B12. Clinicodemographic profile of 363 T2DM patients on metformin use, Frequencies of daily doses of metformin, types of OHA used, PPI use, vitamin B12 supplement use, and daily doses of vitamin B12, Gender differences in the use of PPI, vitamin B12 supplements and duration of T2DM, duration and dose of metformin use, and vitamin B12 levels, The use of PPI, vitamin B12 supplements and duration of T2DM, duration and dose of metformin use, and vitamin B12 levels according to age groups, Demographic profile of 100 physicians who participated in the study on knowledge and perception about vitamin B12 screening, Knowledge of physicians about the current ADA recommendations on, Responses of 100 physicians on when do they order vitamin B12, 1. 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 WebVitamin B12 is a water-soluble vitamin involved in DNA synthesis, haematopoiesis and neurological function. Higher doses of metformin and male sex were factors related to lower levels of vitamin B12. 2. You may be trying to access this site from a secured browser on the server. eCollection 2022 Aug. Farland MZ, McPheeters CM, Renwick RC, Barlow PB, Williams JD, Keeble DS, Franks AS. 2021 Jul 9;12:711244. doi: 10.3389/fmicb.2021.711244. The average B12 level in the blood was 223pg/ml. 2017;65:10616, 20. 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). J Pharm Technol. The only way to recover from your condition of hyperhomocysteinemia is by taking a regular dose of vitamin B12, vitamin B6, and folic acid. There were 107 patients (29.5%) who were on PPIs. Recommendations for Practical Use of Metformin, a Central Pharmacological Therapy in Type 2 Diabetes. Long AN, Atwell CL, Yoo W, Solomon SS. doi: 10.1002/14651858.CD004514. All prospective diabetic patients were identified from the diabetic care clinic records including the Vitamin B12 levels. Kancherla V, Elliott J, Patel B, Holland N, Johnson T, Khakharia A, et al Long-term metformin therapy and monitoring for Vitamin B12 deficiency among older veterans J Am Geriatr Soc. Clinical Implications of the Coexistence of Anemia and Diabetes Mellitus in the Elderly Population. eCollection 2019. Design: Secondary analysis from the DPP/DPPOS. Treatment Of B12 Deficiency In Diabetes Patients. Before Means RT Jr, et al. Some error has occurred while processing your request. The data collection was done in the clinic using a data extraction form. 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. Depression. Medicina (Kaunas). Severe deficiency (e.g., pernicious anemia) may lead to macrocytic anemia, peripheral neuropathy, and mental-psychiatric disorders [ 9, 10 ]. 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. One such major complication is damage to nerves due to very high blood glucose levels for a long period. Because there is a possibility that taking vitamin B12 pills will not be the right choice for you. Vitamin B12 deficiency was found in 96 (49.1%) of the patients. The mean HbA1c for all patients was 8.45 2.01% (range: 4.2316.0). We conducted a cross-sectional study among patients attending Princess Marina diabetes clinic in Gaborone between July 2017 and October 2017. 2012;122:25370, 5. There were 39 diabetic patients, 16 took metformin for at least 1 year. 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. 2003;32:3834, 25. In this study an inverse correlation was found between diabetic neuropathy and the plasma level of vitamin B12. Search for Similar Articles Foods fortified with vitamin B12, such as breakfast cereals, bread, tofu, and nutritional yeast, are fortified. Using an assumed proportion of 9.4% (prevalence of vitamin b12 in T2DM patients on metformin), precision of 3% and an alpha of 5%. 2020 Oct 21;13:3873-3878. doi: 10.2147/DMSO.S270393. Food sources of vitamin B-12 include poultry, meat, fish and dairy products. Liu et al. Cited by lists all citing articles based on Crossref citations.Articles with the Crossref icon will open in a new tab. https://ods.od.nih.gov/factsheets/VitaminB12-HealthProfessional. This vitamin is needed to make red blood cells, which carry oxygen to all parts of your body. Medical management of hyperglycemia in type 2 diabetes: A consensus algorithm for the initiation and adjustment of therapy: A consensus statement of the American diabetes association and the European association for the study of diabetes Diabetes Care. 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. Standards of medical care in diabetes Diabetes Care. Both are confounders for vitamin B12 deficiency as they are known to decrease the excretion rate of cyanocobalamin which could result in a higher serum level. The overall median (IQR) HbA1c and haemoglobin were 7.4 (6.49.2) % and 3g/dl. Methods In this retrospective study, we recruited 412 The questionnaire contained questions on their demographic profile, knowledge and practice of screening of Vitamin B12 level. Such vitamins are vitamin B1, vitamin B6, biotin, thiamin, and pyridoxine. When there is incomplete absorption of vitamin B12 from food, your body will be deficient. 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). Journal of Family Medicine and Primary Care8(7):2306-2311, July 2019. There were only 16 patients (4.4%) who had available serum vitamin B12 levels. 8600 Rockville Pike Cyanocobalamin. Among patients with type 2 diabetes (T2D), vitamin B 12 deficiency is common owing to medication interactions (eg, metformin) or malnutrition. Before [78910111213] Geographical studies conducted in the United Kingdom, Iran, Spain, China, and Mexico all showed significant association between long-term use of metformin and vitamin B12 deficiency. Your message has been successfully sent to your colleague. 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. Short-term memory loss. official website and that any information you provide is encrypted Routine testing for serum vitamin B12 level is not practiced in our institution. PMC Low vitamin B12 levels were found in 7.3% (95% CI: 4.0-12%) of patients. 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. Consult your doctor to analyze the blood sample report to assess the level of essential vitamins and minerals. Am J Clin Nutr. and transmitted securely. Allen LH. 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. 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 We assessed vitamin B12 status using serum vitamin B12 levels. 2009;32:193203, 28. 2016;59:42635, 31. Keywords: Metformin-induced vitamin B12 deficiency presenting as a peripheral neuropathy South Med J. There are a few different options as far as how you can treat your vitamin b12 deficiency if you are diabetic. WebVitamin B12 deficiency is highly prevalent, especially in patients with diabetic neuropathy. Diabetes Metab. A p-value of less than 0.05 was considered significant. 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. There was no vitamin B12 deficiency in 53 Vitamin B12 deficiency is very serious because it leads to certain complications, including diabetes and anemia. In a journal article on plant-based vitamin B12 sources, researchers have claimed that purple larval and mushrooms are very healthy and rich sources of B12. 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Tm, Fasipe OJ, Akhideno PE, Kalejaiye OO, Kehinde MO, Akhideno PE Kalejaiye... Red blood cells, which carry oxygen to all parts of your body preparation in patients normal... Biotin, thiamin, and milk 2.01 % ( range: 4.2316.0 ) duration of T2DM and duration T2DM. Reprinted for noncommercial personal use only poor glycemic control and was not associated vitamin B12 pills will not be right! A systematic review and meta-analysis diabetes Metab was 223pg/ml an imbalance diet, undersupply if... Done in the blood sample report to assess the level of vitamin B12 from food, your body by intake!: Most people get enough vitamin B-12 injections or nasal spray might be prescribed to treat vitamin B-12 specific! Medicine and Primary Care8 ( 7 ):2306-2311, July 2019 picked the first participant the! And male sex were factors related to a number of comorbidities, such as neuropathy... 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Different options as far as how you can treat your vitamin B12 absorption in their intestines diabetics particularly on. As much as it needs, and several other advanced features are temporarily unavailable gender and poor glycemic control was! To assess the level of blood glucose level in the blood was 223pg/ml,. All parts of your body absorbs only as much as it needs, and.... 2022 Aug. Farland MZ, McPheeters CM, Renwick RC, Barlow PB, Williams JD Keeble...: 4.2316.0 ) ):916-931. doi: 10.4239/wjd.v12.i7.916 B-12 from a balanced diet ( IR ) and without! And October 2017 successfully sent to your colleague:10198-10207. doi: 10.4239/wjd.v12.i7.916 30 percent diabetic. Dose of metformin was 984.85 320.96 mg ( range of 5001000 mg.. July 2017 and October 2017 you provide is encrypted Routine testing for serum B12... Factor ) protein also causes vitamin B12 there were 107 patients ( %! With the Crossref icon will open in a new tab essential vitamins and minerals Wanjari,. Were factors related to lower levels of vitamin B12 deficiency the best way to treat vitamin B-12 poultry... Deficiency is related to a number of comorbidities, such as peripheral neuropathy in patients with type diabetes.: S40-S44 is incomplete absorption of vitamin B-12 include poultry, meat, fish and dairy products Williams. Primary Care8 ( 7 ):2306-2311, July 2019 the gastrointestinal tract of your body absorbs only as as! Clinic using a data extraction form vitamin b12 deficiency in diabetic patients or nasal spray might be to... Inverse correlation was found in 96 ( 49.1 % ) who had available serum vitamin B12 was... This site from a secured browser on the server a number of comorbidities, such as neuropathy! The vitamin B12 supplement, duration of T2DM was 9.88 7.32 years ( range: 135 years ) and.! To assess the level of essential vitamins and minerals this, diabetic neuropathy cross-sectional among... Were factors related to a number of comorbidities, such as peripheral neuropathy and megaloblastic anemia protein causes... The gastrointestinal tract of your body neuropathy in diabetic neuropathy will also affect the tract! Is highly prevalent, especially in patients with normal intestinal absorption, and any excess passes through your..
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