ASSOCIATION OF BIOCHEMICAL SERUM VITAMIN B12 DEFECEINCY WITH METFORMIN THERAPY IN TYPE II DIABETES MELLITUS PATIENTS
Dr. Md. Siddique Ahmed Khan and *Dr. Syed Arshaduddin Ahmed
ABSTRACT
Background: Metformin is the only biguanide derivative used to treat type 2 diabetes mellitus (T2DM). Several studies documented that its use contributes to vitamin B12 deficiency in 10–30% of diabetics. The incidence of deficiency varies among populations and studies reported. There is limited data about the effect of metformin use on serum Vitamin B12 levels in type 2 diabetes patients from India. Objective : The objective of this study is to compare the prevalence of vitamin B12 deficiency between two groups of type 2 diabetes mellitus (T2DM) patients treated with or without metformin. Design: The study was a hospital based, case control type of analytical study. Duration: November 2016 to December 2017. Setting: Department of Biochemistry, Shadan Institute of Medical Sciences, Hyderabad. Participants: 200 patients recruited from the medicine outpatient department of Shadan Hospital. Methods: The study group had 100 patients with a diagnosis of T2DM and a prescription history of metformin for ≥15 months and control group has 100 patients with diagnosis of T2DM and no history of metformin use in the past five years. The following data was recorded for each patient: age, sex, weight, height, body mass index (BMI), years with diabetes, total daily dose of and years on metformin. Serum vitamin B12 was measured using an immunoassay method. Data was statistically analyzed. Results: The serum Vitamin B12 levels were 423.47 ± 194.4 in metformin group and 720.88 ± 197.2 in the no metformin group. The difference was statistically significant. Mean serum vitamin B12 levels in vegetarians (520.89 ± 289.009) were significantly lower than in non-vegetarian (661.986 ± 300.897). When adjusted for duration of diabetes, metformin use was associated with lower serum Vitamin B12 levels. Conclusion: Metformin use was associated with lower serum vitamin B12 levels. Based on our results, we strongly recommend the routine screening of subjects with T2DM on metformin for vitamin B12 deficiency due to its high prevalence and the significant clinical effects it may result in.
Keywords: Vitamin B12 Defeceincy, Metformin, Type 2 Diabetes Mellitus.
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