Metformin Induced Vitamin B12 Deficiency Among Patients With Type 2 Diabetes Mellitus.

Indian Journal of Applied Basic Medical Sciences
Year: 2020, Volume: 22(B), Issue. (2)
First page: (172) Last page: (178)
Online ISSN: 2249-7935
Print ISSN: 0975-8917
doi:

Metformin Induced Vitamin B12 Deficiency Among Patients With Type 2 Diabetes Mellitus.
Ranjita V. Gaur1*, Dimple Patel2, 3Rohit Zariwala
1Assistant Professor, 2Associate Professor, Department of Biochemistry, AMC MET Medical College, Maninagar,  Ahmedabad, Gujarat
3Professor & HOD, Department of Forensic Medicine, Gujarat Adani Institute of Medical Sciences, Bhuj, Kutch, Gujarat
Corresponding author email id:ranjitagaur@gmail.com

Online Published on 02-July-2020

ABSTRACT

To study the effect of Metformin induced Vitamin B12 deficiency among patients with Type 2 diabetes mellitus (T2DM).Case – control study. Outpatient clinics of Diabetic Endocrine Research Lab and patients reporting to medicine department of Sheth Vadilal Sarabhai General Hospital ( Smt. NHL Municipal Medical College ) , Ahmedabad, Gujarat . A total of 240 patients, 100 control group healthy normal and nondiabetic 140 study group with Type 2 Diabetes treated with Metformin and not known with a contraindication for the use of Metformin were approached, given informed consent, and entered the study. Addition of Metformin to Insulin Therapy three times a day. Vitamin B12, Folic acid ,Serum Homocysteine. Compare with control, Metformin Treatment was associated with a mean difference in Vitamin B12 -340.26 and confidence 6.71 ( 95 % confidence interval 27.53 to 40.95 : P= < 0.0001) , and in Folate concentration of – 6.24 and confidence 0.18 ( 95% confidence interval 0.74 to 1.1: P=0.026 ) , and an increase in Homocysteine concentration of 18.97 and confidence 0.93 ( 95% confidence interval 3.83 to 5.69 : P= < 0.0001 ) . In addition, decrease Vitamin B12 and Folate could be explained by the increase in Homocysteine. Metformin increases the risk of Vitamin B12 deficiency and Folate, which results in a modest increase in Homocysteine concentration among patients with Type 2 Diabetes. Vitamin B12 Deficiency is preventable , therefore our findings suggests that regular measurements of Vitamin B12 during long term Metformin treatment should be strongly considered .

Keywords

Diabetes, Homocysteine, Insulin, Metformin,Vitamin B12 and Folate.