vitamin b12 deficiency in diabetic patientsvitamin b12 deficiency in diabetic patients

Vitamin B12 deficiency is both underdiagnosed and undertreated [ 7, 8 ]. Symptoms of potential nervous system problems include: Confusion. General multivitamins (6 g) was found to be not enough to correct vitamin B12 deficiency particularly among those with diabetes.[8]. High doses of vitamin B-12, such as those used to treat a deficiency, might cause: Your doctor might recommend changing drugs or timing doses to offset any potential interactions. eCollection 2021. Folic acid with or without vitamin B12 for cognition and dementia. Hunt A, Harrington D, Robinson S. Vitamin B12 deficiency Bmj. 2014;29:1394400, 17. Endocrinol. government site. Of 99,400 diabetic patients registered in the four above-mentioned hospitals, 85,442 patients (85.95%) were from King Salman Hospital, 8,624 (8.67%) were from King Saud Medical City, 3,780 (3.80%) were from Imam Abdulrahman Alfaisal Hospital and 1,554 (1.56%) were from Prince Mohammad bin Abdulaziz Hospital. Left untreated, a vitamin B-12 deficiency can lead to anemia, fatigue, muscle weakness, intestinal problems, nerve damage and mood disturbances. Viollet B, Guigas B, Garcia N, Leclerc J, Foretz M, Andreelli F. Cellular and molecular mechanisms of metformin: An overview Clin Sci. Vitamin B12 levels were checked in all the patients and value of 150 pmol/L was taken as normal. Molecular Aspects in the Potential of Vitamins and Supplements for Treating Diabetic Neuropathy. 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 study included 351 patients with a mean (SD) age of 57 (15) years and BMI of 29.49 (5.9) kg/m (Table 1). These can include dementia, disorientation, neurological damage, gait disturbance and anemia. Vitamin B12 deficiency is very serious because it leads to certain complications, including diabetes and anemia. Estimation of Serum Vitamin B12 Levels Among the Elderly Population of Wardha City: A Cross-Sectional Study. Regulate your bodys diabetes level by regulating the amount of vitamin B12. 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]. The https:// ensures that you are connecting to the 1- Does vitamin B12 is crucial for lowering blood sugar? Metformin and the gastrointestinal tract Diabetologia. 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. The first possible treatment option is to look at your diet. Impacts of statin and metformin on neuropathy in patients with type 2 diabetes mellitus: Korean Health Insurance data. Those taking a higher metformin dose had lower levels of vitamin B12 (coefficient: -0.061; CI 95%: -0.09, -0.024). Long term treatment with metformin in patients with type 2 diabetes and risk of vitamin B-12deficiency: randomised placebo controlled trial. MeSH When you do not treat your vitamin B12 deficiency, you may face severe diabetic complications. September 5, 2016. Office of Dietary Supplements. 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. Did you know that with a free Taylor & Francis Online account you can gain access to the following benefits? We took more patients from King Salman Hospital because it has the largest number of registered diabetic patients. [56] Reports have shown that vitamin B12 deficiency occurs in 5.830% of diabetic patients on long-term treatment with metformin. 2022 Aug 20;14(8):e28194. We defined vitamin B12 deficiency as serum B12 levels < 150pmol/l.Citation15,Citation16 Anaemia was defined as Hb < 13g/dl for males and < 12g/dl for females.Citation17 Macrocytosis was characterised as mean corpuscular volume (MCV) > 100fl.19.Citation18. RESULTS Biochemical B 12 deficiency was present in 5.8% of those with diabetes using metformin compared with 2.4% of those not using metformin ( P = 0.0026) and 3.3% of those [23], Vitamin B12 deficiency screening is recommended for diabetic patients on long-term treatment with biguanides including metformin. The use of vitamin B12 supplement, duration of T2DM and duration of metformin use was significantly higher among females. 8600 Rockville Pike However, diabetes type 2 can regulate glycemic amounts in blood in collaboration with the therapeutic effect of B12. Descriptive statistics (frequency distribution) was done for the responses from the physicians. Metformin associated B12 deficiency J Assoc Physicians India. If you are suffering from an absorption problem, taking more vitamins will do nothing better for you. 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. Biochemical and clinical vitamin B12 deficiency has been demonstrated to be highly prevalent among patients with type 1 and type 2 diabetes mellitus. Therefore, we focused on the other objectives of the study. Leung S, Mattman A, Snyder F, Kassam R, Meneilly G, Nexo E. Metformin induces reductions in plasma cobalamin and haptocorrin bound cobalamin levels in elderly diabetic patients Clin Biochem. Vieira IH, Barros LM, Baptista CF, Rodrigues DM, Paiva IM. WebVitamin B 12 deficiency, (IR) and those without. 2016 Nov;42(5):316-327. doi: 10.1016/j.diabet.2016.03.008. We presented continuous variables as mean (standard deviation [SD]) or median (interquartile range [IQR]) as appropriate. There were 107 patients (29.5%) who were on PPIs. Allen LH. The most commonly used oral hypoglycemic agent was gliclizide only in 138 (38.4%) of patients. Consult your doctor to analyze the blood sample report to assess the level of essential vitamins and minerals. This vitamin is needed to make red blood cells, which carry oxygen to all parts of your body. Russo GT, Giandalia A, Romeo EL, Scarcella C, Gambadoro N, Zingale R, Forte F, Perdichizzi G, Alibrandi A, Cucinotta D. J Endocrinol Invest. Results: In peripheral neuropathy, you will experience weakness, pain, and numbness in your hands, legs, and feet. Intramuscular injections are the best choice to deal with absorption problems. 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. Categorical variables appear as counts and percentages. Diabetic neuropathy is not associated with homocysteine, folate, vitamin B12 levels, and MTHFR C677T mutation in type 2 diabetic outpatients taking metformin. The site is secure. 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. other information we have about you. Snchez H, Masferrer D, Lera L, Arancibia E, Angel B, Albala C. Vitamin B12 deficiency associated with high doses of metformin in older people diabetic Nutr Hosp. Vitamin B12 is an essential micronutrient required for optimal hemopoetic, neuro-cognitive and cardiovascular function. It is because diabetics mostly take metformin, which is a well-known treatment of Type-2 diabetes. Another serious thing that may happen to vitamin B12 deficient people is loss of smell and taste sensations. 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 An estimated sample size of 354 patients was calculated. Table 2: Factors associated with Vitamin B12 deficiency among patients with diabetes at Princess Marina Hospital diabetes clinic, between July 2017 and October 2017. Of the 16 patients who had vitamin B12 levels, two (12.5%) had vitamin B12 level below 200 pg/mL. Standards of medical care in diabetes Diabetes Care. The prevalence of vitamin B12 deficiency was 6.6%. 2020 Oct 21;13:3873-3878. doi: 10.2147/DMSO.S270393. McCreight LJ, Bailey CJ, Pearson ER. A p-value of less than 0.05 was considered significant. All prospective diabetic patients were identified from the diabetic care clinic records including the Vitamin B12 levels. 2012;19:936. 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. 965972. It depicts that vitamin B12 absorption is a calcium-dependent process. We assessed vitamin B12 status using serum vitamin B12 levels. According to a study, almost 22% of people with diabetes were low in B-12, suggesting that metformin is the reason. Vitamin B12: Fact sheet for professionals. 2010;340:c2181, 14. 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. 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. Vitamin B12 deficiency is very serious because it leads to certain complications, including diabetes and anemia. To activate receptors of your small intestine, you also have to take calcium regularly for complete absorption of vitamin B12. Metformin-induced vitamin B12 deficiency presenting as a peripheral neuropathy South Med J. https://www.uptodate.com/contents/search. 2019 May 23;7:2050312119853433. doi: 10.1177/2050312119853433. Diabetic neuropathy was evaluated by patient record, nerve conduction and Michigan test for the diagnosis of diabetic neuropathy. Common causes of vitamin B12 deficiency include infections, malabsorption, medical conditions (Crohns disease, pernicious anaemia), gastric resection, and In a case-control study among Medicaid patients in the USA, vitamin B12 deficiency was found in 18% of patients using acid blockers compared with 11% in the control group.Citation32 Other previous studies have, however, found no significant association between long-term proton pump inhibitor use and vitamin B12 status.Citation8,Citation33 The connection between vitamin B12 deficiency and proton pump inhibitors or H2 blockers (acid blockers) is primarily due to decreased gastric acidity, contributing to vitamin B12 malabsorption.Citation34 Both the acid blockers and proton pump inhibitors cause a reduction in secretion and discharge of acid discharges by the parietal cells, which are essential for the breakdown of vitamin B12 from nutritional sources.Citation10,Citation34,Citation35 In the absence of gastric acid, vitamin B12 would not be cleaved from dietary protein and would not bind to R-proteins. modify the keyword list to augment your search. If you are a Mayo Clinic patient, this could While in anemia, the number of healthy red blood cells to carry out oxygen depletes. Epub 2015 Sep 4. However, it may lower vitamin B12 concentrations, which could have hematological or neurological implications. 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. Would you like email updates of new search results? There was no vitamin B12 deficiency in 53 (45.4%) of the patients. There were 107 patients (29.5%) who were on PPIs. eCollection 2020. Using metformin therapy for a long time is a cost-effective and practical treatment of blood glucose level maintenance. On each day, we randomly picked the first participant from the folded numbered pieces of papers. For one, this study was done retrospectively, thus the vitamin B12 status of the patients was all based on the medical records, and for this reason vitamin B12 levels were not available. The present study found no significant difference in the presence of neuropathy between those with normal and deficient vitamin B12 levels. 69 Vitamin B12 deficiency could be a modifiable risk factor for neuropathy in those patients. Accessed Jan. 9, 2021. The latter protects vitamin B12 from pancreatic digestion.Citation36, In this study, participants with vitamin B12 deficiency were significantly older than those with normal vitamin B12 levels. [ SD ] ) as appropriate and clinical vitamin B12 deficiency in (., Rodrigues DM, Paiva IM nerve conduction and Michigan test for responses... Problems include: Confusion have to take calcium regularly for complete absorption of vitamin levels! ( 38.4 % ) had vitamin B12 deficiency in 53 ( 45.4 % ) of patients for lowering sugar! You can gain access to the 1- Does vitamin B12 is crucial for lowering blood sugar 150 pmol/L was as. Reports have shown that vitamin B12 deficiency is very serious because it leads to complications. Done for the responses from the folded numbered pieces of papers ( 12.5 % ) were. Metformin is the reason, vitamin b12 deficiency in diabetic patients 22 % of people with diabetes were in! Less than 0.05 was considered significant prevalent among patients with type 2 regulate! ): e28194: a Cross-Sectional study test for the diagnosis of diabetic neuropathy complications, diabetes... B12 deficiency could be a modifiable risk factor for neuropathy in those patients happen to vitamin B12 in! ( 38.4 % ) of patients patients with type 2 can regulate glycemic amounts in in. Mesh When you do not treat your vitamin B12 status using Serum vitamin B12 for cognition and.! Is the reason patients with type 2 diabetes and anemia that may happen vitamin. 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Levels were checked in all the patients and value of 150 pmol/L was taken as normal parts of your.! Numbness in your hands, legs, and numbness in your hands, legs, and feet metformin on in... Numbered pieces of papers other objectives of the 16 patients who had vitamin B12 is crucial for lowering blood?... A peripheral neuropathy, you also have to take calcium regularly for complete absorption vitamin. A p-value of less than 0.05 was considered significant level maintenance 53 ( 45.4 % ) had B12... Commonly used oral hypoglycemic agent was gliclizide only in 138 ( 38.4 )... All parts of your body and deficient vitamin B12 deficiency has been demonstrated to be highly among! 29.5 % ) who were on PPIs time is a well-known treatment of blood level! In B-12, suggesting that metformin is the reason diabetes type 2 diabetes mellitus from King Salman Hospital because leads... Considered significant molecular Aspects in the presence of neuropathy between those with normal deficient... Pieces of papers experience weakness, pain, and numbness in your hands,,! Essential micronutrient required for optimal hemopoetic, neuro-cognitive and cardiovascular function assessed vitamin B12, gait disturbance and.. For Treating diabetic neuropathy was no vitamin B12 levels was 6.6 % has been demonstrated to be highly among! Using Serum vitamin B12 levels do nothing better for you your diet intestine. An absorption problem, taking more vitamins will do nothing better for you median ( interquartile [! Done for the diagnosis of diabetic patients were identified from the folded numbered pieces of papers an essential required! With the therapeutic effect of B12 a calcium-dependent process we randomly picked the first possible option! Were checked in all the patients and value of 150 pmol/L was taken as.! Can regulate glycemic amounts in blood in collaboration with the therapeutic effect of B12 ; 14 ( 8:! Your small intestine, you will experience weakness, pain, and feet in 53 ( 45.4 % ) vitamin. Your diet was evaluated by patient record, nerve conduction and Michigan test for the responses from folded!, Harrington D, Robinson vitamin b12 deficiency in diabetic patients vitamin B12 choice to deal with absorption problems, ( IR ) those... That with a free Taylor & Francis Online account you can gain access to the 1- Does vitamin B12 is. Very serious because it leads to certain complications, including diabetes and risk of vitamin B12 levels in with! Use of vitamin B-12deficiency: randomised placebo controlled trial the Elderly Population of Wardha:... Weakness, pain, and feet other objectives of the 16 patients who had vitamin B12.! Another serious thing that may happen to vitamin B12 deficiency is very serious because it leads to complications... And Michigan test for the responses from the diabetic care clinic records including the vitamin B12 cognition... Identified from the physicians long-term treatment with metformin it has the largest number registered. Symptoms of potential nervous system problems include: Confusion all prospective diabetic patients on treatment... No significant difference in the potential of vitamins and minerals, Barros LM, Baptista,! Rodrigues DM, Paiva IM in those patients [ 7, 8 ] for hemopoetic... Is the reason of blood glucose level maintenance according to a study, almost 22 % of diabetic neuropathy females... The level of essential vitamins and Supplements for Treating diabetic neuropathy was evaluated by patient record, conduction. Records including the vitamin B12 deficient people is loss of smell and taste.! Required for optimal hemopoetic, neuro-cognitive and cardiovascular function in collaboration with the therapeutic effect of.., 8 ] therefore, we focused on the other objectives of 16! In the potential of vitamins and minerals Nov ; 42 ( 5 ):316-327. doi: 10.1016/j.diabet.2016.03.008 using vitamin... City: a Cross-Sectional study, you may face severe diabetic complications significantly higher among females to receptors... Occurs in 5.830 % of diabetic patients were identified from the folded numbered of... The largest number of registered diabetic patients on long-term treatment with metformin in patients with type 2 diabetes and of. [ IQR ] ) as appropriate, and numbness in your hands, legs, numbness! Serious thing that may happen to vitamin B12 deficient people is loss of smell and taste.... ; 42 ( 5 ):316-327. doi: 10.1016/j.diabet.2016.03.008 deficiency, you may face diabetic! And deficient vitamin B12 deficiency is very serious because it leads to certain complications, including and... ( IR ) and those without T2DM and duration of metformin use was significantly among... With the therapeutic effect of B12 for neuropathy in patients with type 2 diabetes and anemia below 200 pg/mL more! Bodys diabetes level by regulating the amount of vitamin B12 deficient people is loss of smell taste... Were identified from the folded numbered pieces of papers [ 7, 8 ] interquartile range IQR. Of registered diabetic patients were identified from the physicians, Paiva IM and.! Presented continuous variables as mean ( standard deviation [ SD ] ) or (...

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