PREVALENCE OF LOW VITAMIN B12 LEVELS IN PATIENTS WITH TYPE 2 DIABETES MELLITUS ON METFORMIN IN A TERTIARY TEACHING CARE HOSPITAL
Anandi C.* and Sakthivel Selvaraj
ABSTRACT
Introduction: Metformin is a biguanide and a commonly used oral hypoglycemic agent in treatment of type 2 diabetes mellitus. Duration of diabetes significantly affects the outcome in both treated and untreated patients. It is a known fact that age, duration of diabetes can affect the vitamin B12 status of a patient. Low vitamin B12 level is said to occur in diabetics due to metformin therapy also. There is no universal recommendation to supplement vitamin B12, especially in high risk populations. Studying the biochemical profile to detect vitamin B12 deficiency in these populations will provide useful data to support the need for supplementation. Objectives: To assess the biochemical level of Vitamin B12 in metformin treated type 2 diabetic patients and also to assess the relation between duration of diabetes & development of vitamin B12 deficiency. Methodology: This is a cross sectional observational study of serum vitamin B12 concentration in patients taking metformin for management of type 2 diabetes in GMKMC, Salem. All patients on metformin attending the diabetes outpatient clinics in past six months has been taken up for study after getting informed consent from them. Those on current B12 treatment for any condition were excluded. Data collected included age, duration of disease and metformin therapy, vitamin B12 concentration. Patients were grouped into 3 categories based on their of serum vitamin B12 concentration: Results: Duration of disease and duration of metformin therapy has positive correlation with presence of vitamin b12 deficiency which is also statistically significant with P value less than 0.05,whereas deficiency is much more common in old age patients more than 60 years. Conclusion: Metformin therapy is associated with a higher prevalence of biochemical B12deficiency. Both duration of disease and drug has positive impact on Vitamin B12 level. Hence screening of B12 is advisable in chronic diabetics.
Keywords: Diabetes mellitus, Metformin, Vitamin B12 defeciency.
[Full Text Article]