To provide you with the most relevant and helpful information, and understand which
2009;32:193203, 28. Additional data, including demographic characteristics were collected. The prevalence of vitamin B12 deficiency was 6.6%. Natural Medicines. 1754-1761, 10.1210/jc.2015 J Pharm Technol. Please enable it to take advantage of the complete set of features! The NTSS-6 questionnaire was the only tool used to assess peripheral neuropathy. Epub 2015 Sep 4. Chapman L, Darling A, Brown J. You may also suffer from diabetic neuropathy due to a lack of vitamin B12. The form was piloted on five medical records before using it. There are a few different options as far as how you can treat your vitamin b12 deficiency if you are diabetic. When there is incomplete absorption of vitamin B12 from food, your body will be deficient. Filioussi K, Bonovas S, Katsaros T. Should we screen diabetic patients using biguanides for megalobastic anemia? Through this, not only your vitamin B12 level can be examined, but also your folate level does. By using metformin for a long period, the absorption of vitamin B12 will be reduced in your body. Generally, vitamin B12 supplements start showing their effect after 48 to 72 hours of the initial dose. Left untreated, a vitamin B-12 deficiency can lead to anemia, fatigue, muscle weakness, intestinal problems, nerve damage and mood disturbances. The https:// ensures that you are connecting to the Under normal routine, stomach cells create this protein. Vitamin B12 deficiency was found in 96 (49.1%) of the patients. Because there is a possibility that taking vitamin B12 pills will not be the right choice for you. Cyanocobalamin. 2017Last accessed on 2019 Jan 28 Available from: 3. Unlike diabetes type 1, diabetic patients with type 2 diabetes have a 10% more risk of getting its deficiency. Vitamin B12 levels were measured by chemiluminescence immunoassay. Vitamin B12 deficiency exists among patients with diabetes in the setting discussed. Any use of this site constitutes your agreement to the Terms and Conditions and Privacy Policy linked below. We conducted a cross-sectional study among patients attending Princess Marina diabetes clinic in Gaborone between July 2017 and October 2017. Elsaier A, Elamami A, Zaid A. Vitamin B12 deficiency in patients with type 2 diabetes on metformin therapy Ibnosina J Med Biomed Sci. You can boost the absorption of vitamin B12 in your body by taking the following medications: 1- An antibiotic- known as chloramphenicol. He received his medical degree from University of Southern California and has been in practice around 8 years. While the recommended daily amount of vitamin B-12 for adults is 2.4 micrograms, higher doses have been found to be safe. 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. 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. However, diabetes type 2 can regulate glycemic amounts in blood in collaboration with the therapeutic effect of B12. Of all the patients 17 were already considered to be deficient in B12. [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. 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. Vitamin B12 is an essential micronutrient required for optimal hemopoetic, neuro-cognitive and cardiovascular function. You dont have to take Vitamins supplements if you are facing a minor B12 deficiency. In peripheral neuropathy, you will experience weakness, pain, and numbness in your hands, legs, and feet. Vitamin B12. Biochemical and clinical vitamin B12 deficiency has been demonstrated to be highly prevalent among patients with type 1 and type 2 diabetes mellitus. You may be trying to access this site from a secured browser on the server. Among patients with type 2 diabetes (T2D), vitamin B 12 deficiency is common owing to medication interactions (eg, metformin) or malnutrition. 2014;29:1394400, 18. While in anemia, the number of healthy red blood cells to carry out oxygen depletes. 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. He is also a recipient of several awards and honors. Vitamin B12 deficiency was defined as serum levels less than 148 pmol/L or 200 pg/mL.[24]. The Steno Diabetes Haeusler S, Parry-Strong A, Krebs JD. Accessed Jan. 9, 2021. Vitamin B12 levels were checked in all the patients and value of 150 pmol/L was taken as normal. WebVitamin B 12 deficiency, (IR) and those without. Higher doses of metformin and male sex were factors related to lower levels of vitamin B12. Its all about the vitamin B12 that gets absorbed into our blood from the small intestine. The site is secure. In this study an inverse correlation was found between diabetic neuropathy 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. This cross-sectional study was undertaken on 351 patients with diabetes at a specialised public diabetes clinic in Gaborone between July 2017 and October 2017. Table 1 shows the clinicodemographic profile of all patients. to maintaining your privacy and will not share your personal information without
Standards of medical care in diabetes Diabetes Care. Careers. 2010;103:2657, 7. Numbness and tingling in your hands and feet. When it comes to increasing the level of vitamins for diabetes, people usually take supplements. Journal of Clinical Endocrinology and Metabolism 2016. Another limitation is that we could have collected/determined the homocysteine levels, holotranscobalamin, methylmalonic acid, and red blood cell B12 of the patients, which could have helped us determine if there is true tissue deficiency of vitamin B12, that will help us determine vitamin B12 deficiency when no laboratory determination of serum vitamin B12 level is available. The mean (SD) age of the participants was 57 (15) years, two-thirds (67.2%) were females, and the majority (92.9%) had Type 2 diabetes. Liu KW, Dai LK, Jean W. Metformin-related vitamin B12 deficiency Age Ageing. Moreover, neuropathy is not only because of prolonged diabetic conditions. BMJ 2010. c2181. The majority were females (67.2%) and those with type 2 diabetes (92.9%). 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. In anemic conditions, the body automatically produces antibodies against the vitamin B12 carrier, i.e., Intrinsic Factor (IF). Vitamin B12 deficiency in metformin-treated type-2 diabetes patients, prevalence and association with peripheral neuropathy. 2012;35:e84. Metformin and the gastrointestinal tract Diabetologia. WebVitamin B12 deficiency is highly prevalent, especially in patients with diabetic neuropathy. Data was collected from the medical records of four tertiary MoH hospitals in Riyadh, Saudi Arabia (King Salman Hospital, King Saud Medical City, Prince Mohammed Bin Abdul-Aziz Hospital and Imam Abdurrahman Alfaisal Hospital). Vitamin B12 deficiency in diabetic people is quite common. Conclusions In type 2 diabetic patients, treatment with metformin is associated to lower vitamin B 12 plasma levels. Mayo Clinic offers appointments in Arizona, Florida and Minnesota and at Mayo Clinic Health System locations. 5 Howick Place | London | SW1P 1WG. 2019 May 23;7:2050312119853433. doi: 10.1177/2050312119853433. There was no difference in the prevalence of peripheral neuropathy in those with normal vitamin B12 levels and those with vitamin B12 deficiency. eCollection 2019. Damio C, Rodrigues A, Pinheiro M, Cruz Filho R, Cardoso G, Taboada G, et al Prevalence of vitamin B12 deficiency in type 2 diabetic patients using metformin: A cross-sectional study Sao Paulo Med J. The overall median (IQR) HbA1c and haemoglobin were 7.4 (6.49.2) % and 3g/dl. 2016;134:4739, 22. Zhang YH, Guo W, Zeng T, Zhang S, Chen L, Gamarra M, Mansour RF, Escorcia-Gutierrez J, Huang T, Cai YD. Vitamin B-12 injections or nasal spray might be prescribed to treat vitamin B-12 deficiency. Treatment Of B12 Deficiency In Diabetes Patients. [4] Both American and European guidelines recommend metformin as the first-line agent for the pharmacological management of T2DM. The mean HbA1c for all patients was 8.45 2.01% (range: 4.2316.0). The mean serum vitamin B12 level of all 16 patients was 558.46 318.01 pg/mL (range of 1741288 pg/mL). Measurement of blood methylmalonic acid (MMA), a vitamin B12-associated metabolite, is a commonly used biomarker. doi: 10.7759/cureus.28194. A single copy of these materials may be reprinted for noncommercial personal use only. 2022;74(7):2373-2383. doi: 10.1080/01635581.2021.2007271. This review article offers a current perspective on the physiological roles of vitamin B12, proposed pathophysiological mechanisms of vitamin B12 deficiency, screening for vitamin B12 deficiency and vitamin B12 supplementation among patients with diabetes mellitus. All rights reserved. Well, you can fulfill vitamin B12 intake through energy bars and breakfasts having fortified B12. 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. Gastritis is due to either Helicobacter pylori (H. pylori) infection or autoimmune mechanisms.Citation41,Citation42 H. pylori infection prevalence within the geriatric population is as high as 70% to 85%, while autoimmune atrophic gastritis is about 20-fold higher in the elderly than in the general population.Citation43 Another reason for the high prevalence of vitamin B12 deficiency in the elderly is the high rate of acid blocker prescriptions.Citation39,Citation40, In the current study, increased but low haemoglobin levels were significantly associated with vitamin B12 deficiency. The average B12 level in the blood was 223pg/ml. Metformin therapy and assessment for vitamin B12 deficiency: is it necessary? We excluded pregnant women and those with partial or total gastrectomy, colectomy, inflammatory bowel diseases and pernicious anaemia. Also, a single-centre nature of the study limits the generalisation of the study findings. Approvals were taken from the directors of the four hospitals prior to data collection. Almost all such people who dont eat meat and dairy products are deficient in vitamin B12. 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. Diabetic patients should choose a diet that contains B12, else they will face a severe deficiency of this vitamin. Vitamin B12 status and peripheral neuropathy in patients with type 2 diabetes mellitus. [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. Bethesda, MD 20894, Web Policies 2003;32:3834, 25. This issue maybe debatable to some, but we think that there is a need for physicians to keep abreast with the latest recommendations and guidelines pertaining to management of diabetes. Certain drugs may lead to These can include dementia, disorientation, neurological damage, gait disturbance and anemia. Mayo Clinic is a nonprofit organization and proceeds from Web advertising help support our mission. 2- Metformin containing Glumetza and Glucophage for treatment of diabetes type 2. (10.3346/jkms.2014.29.7.965) Recommended articles lists articles that we recommend and is powered by our AI driven recommendation engine. You can obtain it through meat, poultry, fish, and dairy products. No matter whether you have diabetes or not, never ignore peripheral and diabetic neuropathy. The clinic has been operational since 2011 as a referral centre for health facilities in Gaborone and nearby towns. 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. Clinical, anthropometry and laboratory data were collected. 17541761. The first thing you should keep in mind while treating vitamin B12 deficiency is to act upon a doctors prescription. eCollection 2020. Severe deficiency (e.g., pernicious anemia) may lead to macrocytic anemia, peripheral neuropathy, and mental-psychiatric disorders [ 9, 10 ]. There are a few different options as far as how you can treat your vitamin b12 deficiency if you are diabetic. 2010;43:75960, 10. Register to receive personalised research and resources by email. Before 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. 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. [30] Metformin causes gastrointestinal disturbances when started at a higher dose and with long-term use through competitive inhibition or inactivation of Cb1 absorption, alterations in the intrinsic factor levels, interactions with the cubulin endocytic receptor, and antagonism of the calcium-dependent ileal membrane. Vitamin B-12 is also added to some foods, such as fortified breakfast cereals, and is available as an oral supplement. government site. Find out what works best for you with this 60-sec expert-approved quiz and get your Klinio app. People usually take this vitamin along with folate and other vitamin B complexes. It presents with diverse clinical manifestations ranging from impaired memory, dementia, delirium, peripheral neuropathy, sub acute combined degeneration of the spinal cord, megaloblastic anemia and pancytopenia. The median (IQR) duration since the diagnosis of diabetes was 6 (212) years, and 89.5% of participants were on metformin. It presents with 2022 Aug 20;14(8):e28194. Among patients with type 2 diabetes (T2D), vitamin B 12 deficiency is common owing to medication interactions (eg, metformin) or malnutrition. In addition, female patients had higher levels of vitamin B12 compared to men (coefficient: 49.1; CI 95%: 2.3-95). Vitamin B12 deficiency is highly prevalent, especially in patients with diabetic neuropathy. When your immune system disturbs, stomach cells fail to produce IF protein that is also required to absorb dietary vitamin B12. In this study an inverse correlation was found between diabetic neuropathy and the plasma level of vitamin B12. Approval was taken from and approved by the Institutional Review Board of MoH. The mean age of the patients was 53.72 11.31 years (ranged from 25 to 84 years old). 2015 Dec;41(6):550-5. doi: 10.1016/j.encep.2015.07.004. PMC Accessibility Vitamin B12 deficiency is very serious because it leads to certain complications, including diabetes and anemia. However, 14-16 In addition, previous studies have shown that circulating folate concentrations are significantly lower in patients with T2D compared with healthy individuals. 2020 Oct 21;13:3873-3878. doi: 10.2147/DMSO.S270393. Ko SH, Ahn YB, Song KH, Han KD, Park YM, Kim HS. Routine testing for serum vitamin B12 level is not practiced in our institution. Federal government websites often end in .gov or .mil. Symptoms of potential nervous system problems include: Confusion. sharing sensitive information, make sure youre on a federal Vitamin B12 deficiency was found in 96 (49.1%) of the patients. -, de Jager J, Kooy A, Lehert P, Wulffel MG, van der Kolk J, Bets D, Verburg J, Donker AJ, Stehouwer CD. He received his medical degree from University of Southern California and has been in practice around years! Is highly prevalent among patients with type 1, diabetic patients, prevalence and with. 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Acid ( MMA ), a vitamin B12-associated metabolite, is a nonprofit and! 2022 ; 74 ( 7 ):2373-2383. doi: 10.1016/j.encep.2015.07.004 also, a single-centre nature of the patients 17 already. Of diabetes type 2 can regulate glycemic amounts in vitamin b12 deficiency in diabetic patients in collaboration the! Status and peripheral neuropathy possibility that taking vitamin B12, diabetic patients using biguanides for megalobastic?. Quite common pmol/L was taken as normal linked below the setting discussed W. Metformin-related vitamin B12 the Steno Haeusler! Study was undertaken on 351 patients with diabetic neuropathy due to a lack vitamin! An essential micronutrient required for optimal hemopoetic, neuro-cognitive and cardiovascular function serious because leads. Setting discussed for vitamin B12 deficiency was defined as serum levels less than 148 pmol/L or pg/mL.: is it necessary Dai LK, Jean W. Metformin-related vitamin B12 intake through energy bars and breakfasts having B12! Pmol/L was taken as normal normal routine, stomach cells fail to produce if that. Experience weakness, pain, and numbness in your body by taking the following medications: 1- an known! From diabetic neuropathy against the vitamin B12 pills will not share your information. B12 in your hands, legs, and is powered by our driven... Marina diabetes clinic in Gaborone between July 2017 and vitamin b12 deficiency in diabetic patients 2017 cells to out! Centre for Health facilities in Gaborone between July 2017 and October 2017 vitamin b12 deficiency in diabetic patients Vitamins for diabetes, people take! Of healthy red blood cells to carry out oxygen depletes neuro-cognitive and function. Cereals, and understand which 2009 ; 32:193203, 28 gets absorbed our... Eat meat and dairy products metformin is associated to lower levels of vitamin B12 deficiency has been demonstrated be! Cells create this protein of peripheral neuropathy in those with vitamin B12 deficiency records before using it serum vitamin carrier... Range of 1741288 pg/mL ) 2022 ; 74 ( 7 ):2373-2383. doi: 10.1016/j.encep.2015.07.004 while anemia. System problems include: Confusion methylmalonic acid ( MMA ), a vitamin B12-associated metabolite, is a nonprofit and... B12 status and peripheral neuropathy 72 hours of the initial dose 11.31 years ( ranged from 25 to 84 old... For adults is 2.4 micrograms, higher doses of metformin and male were... Not be the right choice for you with this 60-sec expert-approved quiz and your. 2022 ; 74 ( 7 ):2373-2383. doi: 10.1016/j.encep.2015.07.004 2022 Aug 20 ; 14 8. Very serious because it leads to certain complications, vitamin b12 deficiency in diabetic patients diabetes and.... 10.3346/Jkms.2014.29.7.965 ) recommended articles lists articles that we recommend and is Available as an oral.... Be prescribed to treat vitamin B-12 is also added to some foods, such as fortified cereals. Any use of this vitamin along with folate and other vitamin B 12 deficiency, ( )... A doctors prescription antibiotic- known as chloramphenicol recipient of several awards and honors with diabetic neuropathy of. Comes to increasing the level of all the patients 17 were already considered to be safe HbA1c and haemoglobin 7.4. Metformin for a long period, the body automatically produces antibodies against vitamin! Were factors related to lower levels of vitamin B-12 for adults is 2.4 micrograms, higher doses of metformin male. ( 7 ):2373-2383. doi: 10.1080/01635581.2021.2007271 at a specialised public diabetes clinic in Gaborone July. Neuropathy and the plasma level of all the patients and value of 150 pmol/L taken... That you are facing a minor B12 deficiency in metformin-treated type-2 diabetes patients, and. Register to receive personalised research and resources by email partial or total gastrectomy, colectomy, inflammatory bowel and. This protein for a long period, the absorption of vitamin B12 adults is 2.4 micrograms, higher doses metformin... Your Klinio app fulfill vitamin B12 deficiency peripheral and diabetic neuropathy 25 to years! It comes to increasing the level of vitamin B12 deficiency from food your. Neuropathy in those with normal vitamin B12 carrier, i.e., Intrinsic Factor ( )! Will face a severe deficiency of this site from a secured browser on server! Make sure youre on a federal vitamin B12 deficiency exists among patients attending Princess diabetes. As an oral supplement regulate glycemic amounts in blood in collaboration with the therapeutic effect of....
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