European Journal of Molecular & Clinical Medicine

Abstract

Background: The increasing incidence of type-2 diabetes is a serious health issue worldwide. Its prevalence is associated with poor diet and unhealthy lifestyle choices, and it is characterised by high blood glucose levels that need to be controlled by medication. Metformin is the recommended and most effective first-line drug for type-2 diabetes but its use has also been linked to vitamin B12 deficiency, which increases the risk of peripheral nerve damage.
Aim and Objectives: The aim of the study is to estimate serum levels of Vitamin B12 levels in subjects with Type 2 Diabetes Mellitus. The objectives of the study include to estimate the prevalence of Vitamin B12 deficiency in Type 2 Diabetic subjects and to compare the serum levels Vitamin B12 in Type 2 Diabetic Subjects with or without metformin.
Materials and Methods: We included a total of 140 type 2 Diabetic subjects on metformin therapy for more than 3 years and 60 non-diabetics and non-metformin users. Serum levels of Vitamin B12 was estimated by Chemiluminescence Immuno Assay method.  Serum Vitamin B12 levels of >300 pg/mL was defined as normal, 200-300 pg/mL insufficient and <200 pg/mL as deficient.
Results: We studied a total of 140 type 2 Diabetic metformin users and 60 non-metformin and non-diabetic subjects. We evaluated vitamin B12 levels in both. We found that 6.4% of metformin users had vitamin B12 deficiency, followed by 20.7% had insufficient Vitamin B12 levels and 72.8% had normal vitamin B12 status. Similarly, among non-metformin users 3.33% had deficient vitamin B12 levels, 16.3% had insufficient levels and 80% had normal vitamin B12 levels.
Discussion and Conclusion: Routine screening of Serum Vitamin B12 levels, complete hemogram, and neuropathy status should be done in all diabetic patients at the beginning of metformin therapy, and every 1-2 years thereafter. If any diabetic patient is found to be having low levels of Vitamin B12, they should be well supplemented with the Vitamin before start of metformin therapy.