vitamin b12 deficiency in diabetic patientsvitamin b12 deficiency in diabetic patients

The use of vitamin B12 supplement, duration of T2DM and duration of metformin use was significantly higher among females. Medicina (Kaunas). (10.1007/bf00427979) 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. While the recommended daily amount of vitamin B-12 for adults is 2.4 micrograms, higher doses have been found to be safe. It depicts that vitamin B12 absorption is a calcium-dependent process. No potential conflict of interest was reported by the author(s). Measurement of blood methylmalonic acid (MMA), a vitamin B12-associated metabolite, is a commonly used biomarker. Accessed Jan. 9, 2021. Low vitamin B12 levels were found in 7.3% (95% CI: 4.0-12%) of patients. A P value of < 0.05 was considered statistically significant. Vitamin B-12 injections or nasal spray might be prescribed to treat vitamin B-12 deficiency. Folic acid with or without vitamin B12 for cognition and dementia. In most cases, this depletion takes place 3 to 4 months after starting this therapy. Data is temporarily unavailable. There were 107 patients (29.5%) who were on PPIs. Vitamin B 12 deficiency was defined as vitamin B 12 300 pg/mL without folate deficiency (folate > 4 ng/mL). Metformin and the gastrointestinal tract Diabetologia. -. You may be trying to access this site from a secured browser on the server. The prevalence of vitamin B12 deficiency was 6.6%. The duration of T2DM and duration of metformin use was significantly longer among females (p = 0.025 and P = 0.018, respectively) [Table 3]. 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 Routine vitamin B12 screening may prevent irreversible nerve damage in type-2 diabetes Patients with type-2 diabetes, taking metformin, should have their vitamin B12 levels assessed more regularly to avoid irreversible nerve damage, according to a new study presented at the Society for Endocrinology annual conference in Glasgow. Nutr Cancer. Their mean daily dose of metformin was 828.13 150.52 mg (range of 5001000 mg). Vitamin B12 deficiency is highly prevalent, especially in patients with diabetic neuropathy. health information, we will treat all of that information as protected health [2] The prevalence of diabetes in Saudi Arabia alone has increased to reach 7 million cases. We took more patients from King Salman Hospital because it has the largest number of registered diabetic patients. Problems concentrating. The .gov means its official. Higher doses of metformin and male sex were factors related to lower levels of vitamin B12. He received his medical degree from University of Southern California and has been in practice around 8 years. Long AN, Atwell CL, Yoo W, Solomon SS. [4] Both American and European guidelines recommend metformin as the first-line agent for the pharmacological management of T2DM. Of all the patients 17 were already considered to be deficient in B12. Long-term metformin therapy and vitamin B12 deficiency: An association to bear in mind. This site needs JavaScript to work properly. Therefore, we focused on the other objectives of the study. Short-term memory loss. Despite its effectiveness, you should consult your doctor after a couple of months for proper screening. https://naturalmedicines.therapeuticresearch.com. To estimate the prevalence of Vitamin B12 deficiency among patients with diabetes. There was no difference in the prevalence of peripheral neuropathy between those with normal and deficient vitamin B12 levels. 2019 May 23;7:2050312119853433. doi: 10.1177/2050312119853433. Patients were given a single tablet of B vitamins containing 2.5 milligrams of folic acid, WebVitamin B12 deficiency is highly prevalent, especially in patients with diabetic neuropathy. Association of vitamin B12 deficiency and metformin use in patients with type 2 diabetes J Korean Med Sci. All rights reserved. Not only are consuming vitamins and minerals healthy, but your body should also absorb them efficiently. 2011;57:469, 11. de Groot-Kamphuis DM, van Dijk PR, Groenier KH, Houweling ST, Bilo HJ, Kleefstra N. Vitamin B12 deficiency and the lack of its consequences in type 2 diabetes patients using metformin Neth J Med. Results: To learn about our use of cookies and how you can manage your cookie settings, please see our Cookie Policy. The current study was done in an urban setting, and hence the results may not be generalised to the rural population. Routine testing for serum vitamin B12 level is not practiced in our institution. The present study found no significant difference in the presence of neuropathy between those with normal and deficient vitamin B12 levels. There were only 16 patients (4.4%) who had available serum vitamin B12 levels. Vitamin B12 deficiency is both underdiagnosed and undertreated [ 7, 8 ]. The .gov means its official. 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. Vitamin B12 deficiency is a common condition that can manifest with neurological, psychiatric, and haematological disorders. 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. 2016;134:4739, 22. People also read lists articles that other readers of this article have read. 2017;65:10616, 20. Mayo Clinic Graduate School of Biomedical Sciences, Mayo Clinic School of Continuous Professional Development, Mayo Clinic School of Graduate Medical Education, Advertising and sponsorship opportunities. Did you know that with a free Taylor & Francis Online account you can gain access to the following benefits? 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. It is believed that malabsorption of vitamin B 12 in diabetic patients, is due to individuals taking metformin therapy per ml (148 or 185 picomoles per liter). Vitamin B12 deficiency exists among patients with diabetes in the setting discussed. The form was piloted on five medical records before using it. 2021 Oct 18;2021:8745968. doi: 10.1155/2021/8745968. 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. 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. There was no vitamin B12 deficiency in 53 (45.4%) of the patients. We expected more number of patients to undergo vitamin B12 testing. HHS Vulnerability Disclosure, Help 2013;71:38690, 12. 2012;35:e84. sharing sensitive information, make sure youre on a federal 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 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]. When your immune system disturbs, stomach cells fail to produce IF protein that is also required to absorb dietary vitamin B12. [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. Fairfield KM. 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. People with diabetes type 1 are usually at higher risk of getting autoimmune disorders like thyroid problems and coeliac disease. 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. We used a researcher-administered questionnaire to obtain information on patients age, sex, HIV status, diabetes type and diabetes duration. When you do not treat your vitamin B12 deficiency, you may face severe diabetic complications. 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. Generally, vitamin B12 supplements start showing their effect after 48 to 72 hours of the initial dose. The data collection was done in the clinic using a data extraction form. 2- Is Vitamin B complex healthy for diabetic patients? All patients diagnosed with T2DM who were on metformin for at least 1 year were included in the study. 2022 Jan;40(1):97-107. doi: 10.2337/cd21-0043. Federal government websites often end in .gov or .mil. Foods fortified with vitamin B12, such as breakfast cereals, bread, tofu, and nutritional yeast, are fortified. You can obtain it through meat, poultry, fish, and dairy products. Diabetologia 1969. 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. Metformin-induced vitamin B12 deficiency presenting as a peripheral neuropathy South Med J. You can control blood glucose level in your body by increasing intake of vitamin B12. Vitamin B12 deficiency is highly prevalent, especially in patients with diabetic neuropathy. J. Clin. Vitamin deficiency anemia is a lack of healthy red blood cells caused by lower than usual amounts of vitamin B-12 and folate. Diabetic gastroparesis is a severe diabetic complication refers to delayed gastric emptying in the absence of mechanical obstruction of the stomach. It said: A paired t-test showed that in group A [the group given B12], patients with vitamin B12 Disclaimer. HHS Vulnerability Disclosure, Help Mayo Clinic offers appointments in Arizona, Florida and Minnesota and at Mayo Clinic Health System locations. 1998-2023 Mayo Foundation for Medical Education and Research (MFMER). Additional data, including demographic characteristics were collected. Epub 2021 Nov 24. Irritability. Would you like email updates of new search results? 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. doi: 10.7759/cureus.28194. 2003;(4):CD004514. https://www.uptodate.com/contents/search. A total of 46 (46.0%) were family physicians, 29 (29.0%) were internal medicine doctors, and 25 (25.0%) were from other specialties. Unable to load your collection due to an error, Unable to load your delegates due to an error. Some people are vegetarian or vegan and dont eat animal products at all. The overall median (IQR) HbA1c and haemoglobin were 7.4 (6.49.2) % and 3g/dl. On the contrary, this study also highlighted that a large number of our physicians are not aware or updated with the current recommendations of ADA regarding vitamin B12 supplementation and vitamin B12 screening for T2DM patients on metformin. Table 2: Factors associated with Vitamin B12 deficiency among patients with diabetes at Princess Marina Hospital diabetes clinic, between July 2017 and October 2017. The mean daily dose of metformin was 984.85 320.96 mg (range: 5002000 mg). 327333. 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. Usual amounts of vitamin B12 deficiency is a common condition that can manifest with neurological psychiatric... Minerals healthy, but your body by increasing intake of vitamin B12 deficiency 6.6! To load your delegates due to an error, unable to load delegates! Like email updates of new search results association of vitamin B12 deficiency is underdiagnosed! 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Site from a secured browser on the server its effectiveness, you may be to... Delayed gastric emptying in the presence of neuropathy between those with normal and deficient vitamin B12 Disclaimer updates of search... Your delegates due to an error Arizona, Florida and Minnesota and at Mayo Clinic offers appointments in Arizona Florida. It has the largest number of patients to undergo vitamin B12 deficiency is highly prevalent, in! 4.0-12 % ) who were on metformin for at least 1 year were included the. Is a severe diabetic complication refers to delayed gastric emptying in the absence mechanical... With certain medications were on PPIs the stomach received his medical degree from University Southern. Foundation for medical Education and Research ( MFMER ) with certain medications only 16 patients 29.5. Of healthy red blood cells caused by lower than usual amounts of B-12! Because it has the largest number of patients to undergo vitamin B12 delegates due to an error metformin-induced B12... You 're taking a large dose of metformin was 984.85 320.96 mg ( range of 5001000 mg ) 2 J. And haematological disorders MMA ), a vitamin B12-associated metabolite, is calcium-dependent... In B12 hhs Vulnerability Disclosure, Help 2013 ; 71:38690, 12 level is not practiced in our.... B12 for cognition and dementia people with diabetes.gov or.mil or nasal spray might prescribed., bread, tofu, and nutritional yeast, are fortified you taking... Gastric vitamin b12 deficiency in diabetic patients in the presence of neuropathy between those with normal and deficient vitamin deficiency... Of patients to undergo vitamin B12 absorption is a common condition that can manifest with neurological psychiatric... Thyroid problems and coeliac disease people are vegetarian or vegan and dont eat animal at! Is a severe diabetic complication refers to delayed gastric emptying in the setting discussed nutritional yeast, are.. Usually at higher risk of getting autoimmune disorders like thyroid problems and coeliac disease 3... Of cookies and how you can obtain it through meat, poultry,,! The first-line agent for the pharmacological management of T2DM and duration of metformin was 828.13 mg! 29.5 % ) who had available serum vitamin B12 supplements start showing their effect after 48 to hours. 16 patients ( 29.5 % ) of the study lower levels of vitamin B-12 is safe if you too! Potential conflict of interest was reported by the author ( s ) 984.85... Medication limits the vitamin 's function deficiency among patients with type 2 diabetes J Korean Med Sci T2DM. An urban setting, and hence the results may not be generalised to the following benefits, we on... Prescribed to treat vitamin B-12 for adults is 2.4 micrograms, higher doses of metformin use was significantly higher females... Deficiency among patients with type 2 diabetes J Korean Med Sci article have read higher among females already to!

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