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You can boost the absorption of vitamin B12 in your body by taking the following medications: 1- An antibiotic- known as chloramphenicol. 2021 Jul 15;12(7):916-931. doi: 10.4239/wjd.v12.i7.916. WebGeneral physical symptoms of vitamin B12 deficiency can include: Feeling very tired or weak. Among patients with type 2 diabetes (T2D), vitamin B 12 deficiency is common owing to medication interactions (eg, metformin) or malnutrition. Accessed Jan. 9, 2021. -, Ko SH, Ko SH, Ahn YB, Song KH, Han KD, Park YM, Ko SH, Kim HS. Endocrinol. Additional data, including demographic characteristics were collected. Before The .gov means its official. Methylcobalamin. eCollection 2021. A total of 46 (46.0%) were family physicians, 29 (29.0%) were internal medicine doctors, and 25 (25.0%) were from other specialties. WebVitamin B 12 deficiency, (IR) and those without. Hunt A, Harrington D, Robinson S. Vitamin B12 deficiency Bmj. 327333. Association between metformin and vitamin B12 deficiency in patients with type 2 diabetes: A systematic review and meta-analysis Diabetes Metab. -Chronic treatment should be done with an oral preparation in patients with normal intestinal absorption. WHO Media Centre. Molecular Aspects in the Potential of Vitamins and Supplements for Treating Diabetic Neuropathy. A skilled professional, Dr. Barnett holds certification from the American Board of Internal Medicine with a special focus on endocrinology, diabetes, and metabolism. In diabetes, blood glucose level goes low beyond a certain limit. In diabetes, blood glucose level goes low The deficiency was significantly common with increased age, long duration of metformin use, and acid blockers. 2- Is Vitamin B complex healthy for diabetic patients? PN was significantly associated with female gender and poor glycemic control and was not associated vitamin B12 deficiency or metformin use. 2014;29:1394400, 18. Vitamin B12 affects the dynamics of autonomic nervous system and its deficits has been linked to cardiovascular autonomic neuropathy therefore, vitamin B12 deficiency was Also, a single-centre nature of the study limits the generalisation of the study findings. Please enable scripts and reload this page. Such patients are also more vulnerable to pernicious Armenia. diabetes mellitus; diabetic neuropathies; malabsorption; metformin; prediabetic state; syndromes; vitamin B12. Vitamin B 12 deficiency associated with metformin is relatively common in our area. 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. Vitamin B12 deficiency may occur with metformin treatment, but few studies have assessed risk with long-term use. Alshammari, Amal N.1,; Iqbal, Rafay1; Baksh, Iqra Peer2, 1Department of Family and Community Medicine, Joint Program, Riyadh, Saudi Arabia, 2Department of Dermatology, General Practitioner, Riyadh, Saudi Arabia, Address for correspondence: Dr. Amal N. Alshammari, Department of Family and Community Medicine, Joint Program, Resident R 3, Riyadh, Saudi Arabia. World Health Organization. It presents with Unable to load your collection due to an error, Unable to load your delegates due to an error. It has been suggested that healthy people can have low levels of vitamin B12, and much more vitamin B12 deficiency commonly occurs in around 6% of elderly patients aged 60 years with prevalence increasing with age. 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. 2021 Nov 26;9(33):10198-10207. doi: 10.12998/wjcc.v9.i33.10198. other information we have about you. Epub 2022 May 20. If we combine this information with your protected Some error has occurred while processing your request. official website and that any information you provide is encrypted WebVitamin B12 is a water-soluble vitamin involved in DNA synthesis, haematopoiesis and neurological function. 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 World J Clin Cases. 3- How much vitamin B12 can you take in metformin therapy for diabetics? Wolters Kluwer Health Metformin; type 2 diabetes; Vitamin B12 deficiency; Vitamin B12 screening; Vitamin B12 supplementation. Well, you can fulfill vitamin B12 intake through energy bars and breakfasts having fortified B12. The mean duration of T2DM was 9.88 7.32 years (range: 135 years). Unauthorized use of these marks is strictly prohibited. Treatment Of B12 Deficiency In Diabetes Patients. The duration of T2DM and duration of metformin use was significantly longer among females (p = 0.025 and P = 0.018, respectively) [Table 3]. Did you know that with a free Taylor & Francis Online account you can gain access to the following benefits? Lets read how type 1 and 2 diabetes affect the level of Vitamin B12 in your body. 2009;32:193203, 28. 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. 2003;(4):CD004514. Routine testing for serum vitamin B12 level is not practiced in our institution. Nutr Cancer. 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. Top Warning Signs of B12 DeficiencyTiredness. If you often feel exhausted, regardless of how much sleep youve gotten or how much energy youve exerted, it could be a sign that your body is lacking Mood swings. Do you find yourself experiencing a variety of emotions throughout any given day? It may result in depression. Digestive issues. Inflammation of the mouth and tongue. Insomnia. More items 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. 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. (10.3346/jkms.2014.29.7.965) This site needs JavaScript to work properly. [24] Although vitamin B12 deficiency is a common but not serious condition, it is deemed important to treat patients to avoid neurological impairment even if there may be discordance between the results and clinical features. McCreight LJ, Bailey CJ, Pearson ER. Later on, deficiency in vitamin b12 was reported through a Brazilian study of people receiving extended treatment with Metformin. Liu et al. Epub 2021 Nov 24. Through this, not only your vitamin B12 level can be examined, but also your folate level does. Any use of this site constitutes your agreement to the Terms and Conditions and Privacy Policy linked below. This vitamin is needed to make red blood cells, which carry oxygen to all parts of your body. Hallucinations. There were 205 patients 56.5% who had a daily dose of 750 mg of metformin. People who take metformin for type 2 diabetes have lower levels of vitamin B12. Abstract Background Metformin is first-line therapy for patients with diabetes. When taken at appropriate doses, vitamin B-12 supplements are generally considered safe. 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. Medicina (Kaunas). Vitamin B12 deficiency was defined by levels < 150pmol/l. Recommended articles lists articles that we recommend and is powered by our AI driven recommendation engine. Office of Dietary Supplements. You may also suffer from diabetic neuropathy due to a lack of vitamin B12. https://www.wolterskluwercdi.com/facts-comparisons-online/. Vegans and vegetarians are more prone to its deficiency just because vitamin B12 is not present in plants. Elsaier A, Elamami A, Zaid A. Vitamin B12 deficiency in patients with type 2 diabetes on metformin therapy Ibnosina J Med Biomed Sci. 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. There was no vitamin B12 deficiency in 53 (45.4%) of the patients. Vitamin B12 deficiency was found in 96 (49.1%) of the patients. 2006;35:2001, 6. Left untreated, a vitamin B-12 deficiency can lead to anemia, fatigue, muscle weakness, intestinal problems, nerve damage and mood disturbances. 14-16 In addition, previous studies have shown that circulating folate concentrations are significantly lower in patients with T2D compared with healthy individuals. Keywords: 2014;349:g5226, 26. Of all the patients 17 were already considered to be deficient in B12. Almost all such people who dont eat meat and dairy products are deficient in vitamin B12. . 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. The majority were females (67.2%) and those with type 2 diabetes (92.9%). Vitamin B12 deficiency is both underdiagnosed and undertreated [ 7, 8 ]. Federal government websites often end in .gov or .mil. Clinical Implications of the Coexistence of Anemia and Diabetes Mellitus in the Elderly Population. Diabetic patients should choose a diet that contains B12, else they will face a severe deficiency of this vitamin. Bookshelf The mean HbA1c for all patients was 8.45 2.01% (range: 4.2316.0). Table 1 shows the clinicodemographic profile of all patients. In addition, female patients had higher levels of vitamin B12 compared to men (coefficient: 49.1; CI 95%: 2.3-95). The questionnaire contained questions on their demographic profile, knowledge and practice of screening of Vitamin B12 level. Loss of balance. 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. 1754-1761, 10.1210/jc.2015 Vitamin B12 deficiency was found in 96 (49.1%) of the patients. There was no vitamin B12 deficiency in 53 (45.4%) of the patients. WebA B12 supplement can be helpful if you have type 2 diabetes and are deficient in the vitamin. People with diabetes type 1 are usually at higher risk of getting autoimmune disorders like thyroid problems and coeliac disease. information submitted for this request. Accessibility FOIA [2] In 2015, diabetes was the leading cause of 1.6 million deaths and World Health Orgnization projects that diabetes will be the seventh most important cause of death by 2030. Clipboard, Search History, and several other advanced features are temporarily unavailable. 2017;65:10616, 20. PMC Patients were given a single tablet of B vitamins containing 2.5 milligrams of folic acid, 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. Vitamin B-12 supplements also are recommended for women who are pregnant or breastfeeding exclusively and follow vegetarian or vegan diets. Many such vitamin B12 rich foods can be obtained from animal and non-animal sources. Design: Secondary analysis from the DPP/DPPOS. Older adults and people with digestive tract conditions that affect absorption of nutrients also are susceptible to vitamin B-12 deficiency. health information, we will treat all of that information as protected health We assessed vitamin B12 status using serum vitamin B12 levels. 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. 14-16 In addition, previous studies have shown that circulating folate concentrations are significantly lower in patients with T2D compared with healthy individuals. Bookshelf Accessibility Facts & Comparisons eAnswers. 17541761. BMC Pharmacol Toxicol. There were 39 diabetic patients, 16 took metformin for at least 1 year. Michalak SS, Wolny-Rokicka E, Nowakowska E, Michalak M, Gil L. J Diabetes Res. 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]. By using metformin for a long period, the absorption of vitamin B12 will be reduced in your body. In this study an inverse correlation was found between diabetic neuropathy and the plasma level of vitamin B12. information highlighted below and resubmit the form. We conducted a cross-sectional study among patients attending Princess Marina diabetes clinic in Gaborone between July 2017 and October 2017. 2021 Oct 18;2021:8745968. doi: 10.1155/2021/8745968. People with diabetes taking metformin are at a higher risk of developing B12 deficiency, because this medication can reduce vitamin B12 absorption in the body . If youre Eligible patients were males and females, aged 18 years, diagnosed with type 1 and type 2 diabetes mellitus. For more information, please refer to our Privacy Policy. 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. There were 39 diabetic patients, 16 took metformin for at least 1 year. 1754-1761, 10.1210/jc.2015 WebConclusion: The prevalence of vitamin B12 deficiency is considerable among diabetic patients on metformin therapy. There were 206 (56.7%) males and 157 (43.3%) females, and 337 (92.8%) were Saudis. Recommendations for Practical Use of Metformin, a Central Pharmacological Therapy in Type 2 Diabetes. Of the 16 patients who had vitamin B12 levels, two (12.5%) had vitamin B12 level below 200 pg/mL. 2017;354:16571, 19. Results were expressed as numbers and percentages for categorical variables and as mean and standard deviation (SD) for continuous variables. So, consult with your doctor if you are at high risk or have any of the symptoms. MeSH Chi-square test was used to determine significant difference between two proportions or groups. Experiencing nausea, vomiting or diarrhea. You can control blood glucose level in your body by increasing intake of vitamin B12. Before Results About 29.66% of diabetic patients had confirmed the B12 insufficiency through laboratory tests. There were only 16 patients (4.4%) who had available serum vitamin B12 levels. The form was piloted on five medical records before using it. Journal of Clinical Endocrinology and Metabolism 2016. Further research is needed to confirm the need for routine We presented continuous variables as mean (standard deviation [SD]) or median (interquartile range [IQR]) as appropriate. Approvals were taken from the directors of the four hospitals prior to data collection. Besides an imbalance diet, undersupply of IF (Intrinsic Factor) protein also causes vitamin B12 deficiency. Problems concentrating. 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.
