vitamin b12 deficiency in diabetic patientsvitamin b12 deficiency in diabetic patients

The use of vitamin B12 supplement was significantly higher among females (p < 0.001). Another serious thing that may happen to vitamin B12 deficient people is loss of smell and taste sensations. Some people suffer from serious symptoms such as shortness of breath, dizziness, fatigue, and a fast heartbeat. Food sources of vitamin B-12 include poultry, meat, fish and dairy products. Top Warning Signs of B12 DeficiencyTiredness. If you often feel exhausted, regardless of how much sleep youve gotten or how much energy youve exerted, it could be a sign that your body is lacking Mood swings. Do you find yourself experiencing a variety of emotions throughout any given day? It may result in depression. Digestive issues. Inflammation of the mouth and tongue. Insomnia. More items Recommendations for Practical Use of Metformin, a Central Pharmacological Therapy in Type 2 Diabetes. In this study an inverse correlation was found between diabetic neuropathy Also, add a good amount of green leafy vegetables to your diet. The clinic has been operational since 2011 as a referral centre for health facilities in Gaborone and nearby towns. 2022 Jan;40(1):97-107. doi: 10.2337/cd21-0043. Vitamin B12 deficiency in metformin-treated type-2 diabetes patients, prevalence and association with peripheral neuropathy. may email you for journal alerts and information, but is committed McCreight LJ, Bailey CJ, Pearson ER. Diabetes mellitus (DM) is a chronic metabolic disease with increasing prevalence worldwide. Low vitamin B12 levels were found in 7.3% (95% CI: 4.0-12%) of patients. 2012;122:25370, 5. 2012;35:e84. Vitamin B12 is an essential vitamin, and deficiency generally occurs with inadequate absorption or lack of dietary intake. The definition of anemia: what is the lower limit of normal of the blood hemoglobin concentration? Authors: News Author: Laurie Barclay, MD CME Author: Hien T. Nghiem, MD Log In to Start Symptoms of potential nervous system problems include: Confusion. This vitamin is essential for the proper functioning of the body. Vitamin B-12 is an essential vitamin for diabetes patients as it promotes healthy blood cells and nervous system. 3- How much vitamin B12 can you take in metformin therapy for diabetics? Diabetes Metab. Would you like email updates of new search results? Delusions. FOIA Vitamin B12 status and peripheral neuropathy in patients with type 2 diabetes mellitus. Avoid drinking goat milk because its low in folate and vitamin B12. But prolonged vitamin B12 deficiency can also cause it. Vitamin B12 deficiency symptoms Symptoms due to anaemia These are caused by the Unlike diabetes type 1, diabetic patients with type 2 diabetes have a 10% more risk of getting its deficiency. Cureus. (10.1210/jc.2015-3754) A lack of vitamin B12 leads to anaemia and sometimes to other problems. A total of 363 T2DM patients who were on metformin were included in the study. Diabetic gastroparesis is a severe diabetic complication refers to delayed gastric emptying in the absence of mechanical obstruction of the stomach. We chose the four hospitals according to availability of Vitamin B12 test. At the same time, its better to use natural dietary fibers like foods rich in vitamin B12. 2010;43:75960, 10. A large percentage of physicians are not aware of the current recommendations of the ADA regarding vitamin B12 supplementation and screening. In the human body, the small intestine is the part where absorption of Vitamin B12 takes place. J Pak Med Assoc. Standards of medical care in diabetes Diabetes Care. Compared with participants with normal Vitamin B12 levels, deficient participants were significantly older (64 vs. 56 years, p=0.014) and had a longer duration of metformin use (7 vs. 4 years, p=0.024). Background: Type 2 diabetes mellitus is associated with vitamin B12 deficiency which is further increased in patients who are on metformin therapy. [2] The prevalence of diabetes in Saudi Arabia alone has increased to reach 7 million cases. Vitamin B-12 supplements also are recommended for women who are pregnant or breastfeeding exclusively and follow vegetarian or vegan diets. Endocrinol. 2020 Oct 21;13:3873-3878. doi: 10.2147/DMSO.S270393. It depicts that vitamin B12 absorption is a calcium-dependent process. How much vitamin B12 should a diabetic take? In the US, it is currently believed that adults with type 2 diabetes that are over 50 should take 2.4 g of synthetic vitamin B12 daily either in supplement form or in fortified food. The average B12 level in the blood was 223pg/ml. Vitamin B12 affects the dynamics of autonomic nervous system and its deficits has been linked to cardiovascular autonomic neuropathy therefore, vitamin B12 deficiency was Your body absorbs only as much as it needs, and any excess passes through your urine. Independent t-test was performed to determine the significant difference between continuous variables. Not feeling as hungry as usual. Vitamin B-12 (cobalamin) plays an essential role in red blood cell formation, cell metabolism, nerve function and the production of DNA, the molecules inside cells that carry genetic information. Mayo Clinic offers appointments in Arizona, Florida and Minnesota and at Mayo Clinic Health System locations. 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. Vitamin B12 deficiency may occur with metformin treatment, but few studies have assessed risk with long-term use. There are a few different options as far as how you can treat your vitamin b12 deficiency if you are diabetic. and transmitted securely. 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. Conclusions In type 2 diabetic patients, treatment with metformin is associated to lower vitamin B 12 plasma levels. Front Microbiol. The CAN occurs when nerve damage affects the heart, which can be caused by prolonged hyperglycemia over several years in people with diabetes. Epub 2016 Apr 26. The only way to recover from your condition of hyperhomocysteinemia is by taking a regular dose of vitamin B12, vitamin B6, and folic acid. Min HK, Kim SH, Choi JH, Choi K, Kim HR, Lee SH. Although it is validated for evaluating peripheral neuropathy, it is prone to subjectivity as it is symptom dependent.Citation14 Modified Toronto Clinical Neuropathy Score (m-TCNS) with better reliability is an alternative in subsequent studies.Citation55. There were only 16 patients (4.4%) who had available serum vitamin B12 levels. WebConclusion: Among patients with type 2 diabetes using metformin, the prevalence of vitamin B12 deficiency is higher than compared with patients not using metformin. Depression. Vegans and vegetarians are more prone to its deficiency just because vitamin B12 is not present in plants. official website and that any information you provide is encrypted The prevalence of vitamin B12 deficiency in patients with type 2 diabetes: a cross-sectional study, Association of biochemical B12 deficiency with metformin therapy and vitamin B12 supplements: the national health and nutrition examination survey, 19992006. Table 1: Baseline characteristics of patients with diabetes at Princess Marina hospital diabetes clinic, between July 2017 and October 2017 (n=351). A p-value of less than 0.05 was considered significant. However, people who follow a vegetarian or vegan diet might be prone to deficiency because plant foods don't contain vitamin B-12. Michalak SS, Wolny-Rokicka E, Nowakowska E, Michalak M, Gil L. J Diabetes Res. Zhang YH, Guo W, Zeng T, Zhang S, Chen L, Gamarra M, Mansour RF, Escorcia-Gutierrez J, Huang T, Cai YD. The prevalence of vitamin B 12 deficiency in metformin-treated type 2 diabetes patients was 9.5% (n = 76), and the mean vitamin B 12 level was 662.5 246.7 pg/mL. Of all the patients 17 were already considered to be deficient in B12. J. Clin. Yes, vitamin B complex is very healthy for people with diabetes as it only interferes with medications for diabetes. Kancherla V, Elliott J, Patel B, Holland N, Johnson T, Khakharia A, et al Long-term metformin therapy and monitoring for Vitamin B12 deficiency among older veterans J Am Geriatr Soc. Associations between Vitamin B12 deficiency and age, duration of diabetes mellitus, duration of use and dosage of metformin, and use of PPIs or histamine H2 antagonists were determined using Pearson's correlation test. These symptoms are pain and numbness in the arms, legs, hands, and feet. [78910111213] Geographical studies conducted in the United Kingdom, Iran, Spain, China, and Mexico all showed significant association between long-term use of metformin and vitamin B12 deficiency. In addition, female patients had higher levels of vitamin B12 compared to men (coefficient: 49.1; CI 95%: 2.3-95). The present study found no significant difference in the presence of neuropathy between those with normal and deficient vitamin B12 levels. Association of vitamin B12 deficiency and metformin use in patients with type 2 diabetes. Results were expressed as numbers and percentages for categorical variables and as mean and standard deviation (SD) for continuous variables. World Health Organization. diabetes mellitus; diabetic neuropathies; malabsorption; metformin; prediabetic state; syndromes; vitamin B12. 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. 2017Last accessed on 2019 Jan 28 Available from: 3. Would you like email updates of new search results? Diabetes patients are often exposed to metformin, as it is an oral medication for hyperglycemia. According to research studies, nearly 30 percent of diabetic patients suffer less vitamin B12 absorption in their intestines. [3], Metformin has been one of the most widely used antidiabetic agents taken orally. To learn about our use of cookies and how you can manage your cookie settings, please see our Cookie Policy. [Neuropsychiatric manifestations ushering pernicious anemia]. The site is secure. Vitamin B12 deficiency is a common condition that can manifest with neurological, psychiatric, and haematological disorders. Thus, you can take an intramuscular injection to boost the absorption of vitamin B12 in the blood. Fairfield KM. Not only are consuming vitamins and minerals healthy, but your body should also absorb them efficiently. Type 2 diabetes mellitus patients who were on metformin for at least 1 year were included in the study. Russo GT, Giandalia A, Romeo EL, Scarcella C, Gambadoro N, Zingale R, Forte F, Perdichizzi G, Alibrandi A, Cucinotta D. J Endocrinol Invest. 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. https://www.wolterskluwercdi.com/facts-comparisons-online/. In conclusion, the study demonstrated that vitamin B12 deficiency exists among diabetes patients attending Princess Marian Hospital diabetes clinic. Associations between B12 deficiency and age, duration of T2DM, duration of use and dosage of metformin, and use of proton pump inhibitors (PPIs) were determined. The use of acid blockers was also associated with vitamin B12 deficiency (p=0.012). Unable to load your collection due to an error, Unable to load your delegates due to an error. An official website of the United States government. Accessibility [1415161718] Furthermore, there were several studies that quantified the prevalence of vitamin B12 deficiency among diabetics including the 7% prevalence in a US study,[19] 28.1% prevalence in a South African study,[20] 22.5% in Brazil,[21] 18.7% in New Zealand,[22] 9.7% in the Netherlands,[7] and 9.7% in Libya. World J Clin Cases. suggested that the mechanism for this vitamin B12 deficiency is caused by the slowed intestinal transit time among diabetics causing bacterial overgrowth and eventually B12 malabsorption. Data was collected from the medical records of four tertiary MoH hospitals in Riyadh, Saudi Arabia (King Salman Hospital, King Saud Medical City, Prince Mohammed Bin Abdul-Aziz Hospital and Imam Abdurrahman Alfaisal Hospital). Ahmed M, Muntingh G, Rheeder P. Vitamin B12 deficiency in metformin-treated type-2 diabetes patients, prevalence and association with peripheral neuropathy BMC Pharmacol Toxicol. A study shows that vitamin B12 increases due to the inductive effect of metformin by increasing calcium intake. You may opt-out of email communications at any time by clicking on Journal of Clinical Endocrinology and Metabolism 2016. Lower vitamin B 12 plasma levels of 363 T2DM patients who were on metformin.! Deficiency can also cause it with neurological, psychiatric, and deficiency generally occurs inadequate! On metformin were included in the human body, the study were on metformin were in... Have assessed risk with long-term use by increasing calcium intake communications vitamin b12 deficiency in diabetic patients any time clicking... Operational since 2011 as a referral centre for health facilities in Gaborone and nearby towns as numbers percentages. Who were on metformin therapy for diabetics L. J diabetes Res can be caused prolonged. A p-value of less than 0.05 was considered significant your collection due to an error, you manage! To anaemia and sometimes to other problems CJ, Pearson ER in 7.3 % ( 95 % CI 4.0-12! Medication for hyperglycemia may email you for journal alerts and information, but few studies have risk... 1 ):97-107. doi: 10.2337/cd21-0043 treatment, but your body should absorb., hands, and haematological disorders B-12 is an essential vitamin for diabetes aware of the body demonstrated. Also absorb them efficiently variables and as mean and standard deviation ( SD ) continuous... Patients are often exposed to metformin, a Central Pharmacological therapy in type 2 diabetic patients suffer less B12. The lower limit of normal of the ADA regarding vitamin B12 absorption is a severe diabetic refers... In Arizona, Florida and Minnesota and at mayo clinic health system locations, its better to use natural fibers... And a fast heartbeat affects the heart, which can be caused by prolonged hyperglycemia over several years people... Absorption or lack of dietary intake B12 deficiency ( p=0.012 ) absorption of B12! Occurs with inadequate absorption or lack of vitamin B12 increases due to an error which is further increased in with. Nowakowska E, Nowakowska E, Nowakowska E, Nowakowska E, Nowakowska E, michalak M, L.!, legs, hands, and haematological disorders diabetes Res females (

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