Data is temporarily unavailable. 405412. Vitamin B12 deficiency is a common condition that can manifest with neurological, psychiatric, and haematological disorders. Clinical Implications of the Coexistence of Anemia and Diabetes Mellitus in the Elderly Population. So, it was not possible to get a valid estimate of the deficiency prevalence. Impacts of statin and metformin on neuropathy in patients with type 2 diabetes mellitus: Korean Health Insurance data. 2013;36:S1166, 27. eCollection 2021. Disclaimer. 1754-1761, 10.1210/jc.2015 Almost all such people who dont eat meat and dairy products are deficient in vitamin B12. Cochrane Database Syst Rev. If a patients mood is low at the same time, this can easily be interpreted as depression. This content does not have an English version. Taking this diabetes drug might reduce your body's ability to absorb vitamin B-12. Such vitamins are vitamin B1, vitamin B6, biotin, thiamin, and pyridoxine. Hallucinations. The mean serum vitamin B12 level of all 16 patients was 558.46 318.01 pg/mL (range of 1741288 pg/mL). Table 2: Factors associated with Vitamin B12 deficiency among patients with diabetes at Princess Marina Hospital diabetes clinic, between July 2017 and October 2017. Of the 16 patients who had vitamin B12 levels, two (12.5%) had vitamin B12 level below 200 pg/mL. A lack of vitamin B12 leads to anaemia and sometimes to other problems. Two common types of GERD medicines have been associated with B-12 deficiency to varying degrees: H-2-receptor blockers. Search for Similar Articles Allen LH. Accessed Jan. 9, 2021. We took more patients from King Salman Hospital because it has the largest number of registered diabetic patients. Association of vitamin B12 deficiency and metformin use in patients with type 2 diabetes. Approval was taken from and approved by the Institutional Review Board of MoH. Avoid drinking goat milk because its low in folate and vitamin B12. privacy practices. There were only 16 patients (4.4%) who had available serum vitamin B12 levels. How common is vitamin B-12 deficiency? The recommended daily amount of vitamin B-12 for adults is 2.4 micrograms. Instead of lowering blood glucose levels, the level of vitamin B12 gets lowered itself in diabetic patients. A total of 363 T2DM patients who were on metformin were included in the study. Measurement of blood methylmalonic acid (MMA), a vitamin B12-associated metabolite, is a commonly used biomarker. One standard first-line treatment for diabetes is metformin, which was reported to increase the risk for vitamin B12 deficiency. [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. [23], Vitamin B12 deficiency screening is recommended for diabetic patients on long-term treatment with biguanides including metformin. Diabetologia 1969. The countries in the MENA region now have some of the highest rates of diabetes. Causes and pathophysiology of vitamin B12 and folate deficiencies. Diabetic patients are at risk of becoming more vitamin B12 deficient to various problems. The most notable risk factor associated with vitamin B12 deficiency in adult individuals with diabetes in clinical practice is long term and high dose metformin therapy [46]. The https:// ensures that you are connecting to the 2022;74(7):2373-2383. doi: 10.1080/01635581.2021.2007271. Higher doses of metformin and male sex were factors related to lower levels of vitamin B12. The prevalence of vitamin B12 deficiency increases with age due to either inadequate dietary intake or impaired vitamin B12 absorption.Citation37 Ageing is associated with decreases in taste acuity and smell, deteriorating dental health and a reduction of physical activity, which may all affect nutrient intake.Citation38 Insufficient nutritional intake of vitamin B12 accounts for about 2% of the vitamin B12 deficiency in the elderly, especially those living in institutions.Citation39 Vitamin B12 malabsorption is the most frequent cause of vitamin B12 deficiency in the elderly, accounting for about 40% to 70% of cases.Citation39,Citation40 It is caused by atrophic gastritis that occurs in 20% to 50% of the elderly population. Eligible patients were males and females, aged 18 years, diagnosed with type 1 and type 2 diabetes mellitus. Conclusions: Berchtold P, Bolli P, Arbenz U, Keiser G. Disturbance of intestinal absorption following metformin therapy (observations on the mode of action of biguanides) [in German]. The patients on metformin had statistically lower 2019 Aug;69(Suppl 3)(8):S40-S44. and transmitted securely. With this condition, your body does not have enough healthy red blood cells, due to a lack (deficiency) of vitamin B; It is one of Medicina (Kaunas). Warning: Consult your Doctor first before treating vitamin B12 deficiency either way. This vitamin is needed to make red blood cells, which carry oxygen to all parts of your body. The mean HbA1c for all patients was 8.45 2.01% (range: 4.2316.0). Its all about the vitamin B12 that gets absorbed into our blood from the small intestine. A study shows that vitamin B12 increases due to the inductive effect of metformin by increasing calcium intake. It depicts that vitamin B12 absorption is a calcium-dependent process. doi: 10.1002/14651858.CD004514. Metab., 101 (2016), pp. 1 The prevalence of vitamin B12 deficiency in diabetes mellitus While the recommended daily amount of vitamin B-12 for adults is 2.4 micrograms, higher doses have been found to be safe. Advertising revenue supports our not-for-profit mission. 2016;134:4739, 22. https://ods.od.nih.gov/factsheets/VitaminB12-HealthProfessional. Moreover, neuropathy is not only because of prolonged diabetic conditions. Register a free Taylor & Francis Online account today to boost your research and gain these benefits: Vitamin B12 deficiency in patients with diabetes at a specialised diabetes clinic, Botswana, a Department of Medicine, Princess Marina Hospital, Gaborone, Botswana, a Department of Medicine, Princess Marina Hospital, Gaborone, Botswana;b Department of Internal Medicine, University of Botswana, Gaborone, Botswana. Facts & Comparisons eAnswers. Aust Fam Physician. Sharma R, Wanjari MB, Raut A, Gujar S, Gledina A, Kantode VV, Munjewar PK. Bethesda, MD 20894, Web Policies You might be thinking about how you can take vitamin B12 naturally when you are a vegetarian. The data collection was done in the clinic using a data extraction form. The average B12 level in the blood was 223pg/ml. The only way to recover from your condition of hyperhomocysteinemia is by taking a regular dose of vitamin B12, vitamin B6, and folic acid. It presents with The first possible treatment option is to look at your diet. The PubMed wordmark and PubMed logo are registered trademarks of the U.S. Department of Health and Human Services (HHS). 2016 Nov;42(5):316-327. doi: 10.1016/j.diabet.2016.03.008. Abstract Background Metformin is first-line therapy for patients with diabetes. Vitamin B-12 is an essential vitamin for diabetes patients as it promotes healthy blood cells and nervous system. Office of Dietary Supplements. Besides this, diabetic neuropathy will also affect the gastrointestinal tract of your body. Table 1 shows the clinicodemographic profile of all patients. Metformin and the gastrointestinal tract Diabetologia. There is a need to inject diabetic patients with a dose of 1mg. World J Diabetes. Vitamin B-12 deficiency is not common in the U.S. Diabetes mellitus (DM) is a chronic metabolic disease with increasing prevalence worldwide. 2010;43:75960, 10. Accessed Jan. 9, 2021. Vitamin B 12 deficiency was defined as vitamin B 12 300 pg/mL without folate deficiency (folate > 4 ng/mL). Accessibility Hyperhomocysteinaemia and vitamin B12 deficiency are often detected in patients affected with diseases associated with neuropathy such as diabetes, 66 alcoholism, 67 Parkinsons disease (treated with L-dopa), 68 or HIV infection. A total of 46 (46.0%) were family physicians, 29 (29.0%) were internal medicine doctors, and 25 (25.0%) were from other specialties. Careers. Type 1 diabetics and patients who had a history of pernicious anemia, chronic renal insufficiency, prior bariatric surgery, prior gastrectomy, vitamin B12 supplementation with B12 injections or an oral dose of >500 g/day, prior ileum resection, or Crohn's disease were excluded from the study. In both diabetes type 1 and type 2, diabetic patients experience its deficiency. You dont have to take Vitamins supplements if you are facing a minor B12 deficiency. 2014;29:1394400, 18. There were 39 diabetic patients, 16 took metformin for at least 1 year. Patients were given a single tablet of B vitamins containing 2.5 milligrams of folic acid, A total of 100 physicians responded and consented to participate in the study. Vegans and vegetarians are more prone to its deficiency just because vitamin B12 is not present in plants. 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. Long-term metformin therapy and vitamin B12 deficiency: An association to bear in mind. and transmitted securely. 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. Mayo Clinic does not endorse companies or products. Patients were given a single tablet of B vitamins containing 2.5 milligrams of folic acid, 25 milligrams of vitamin B6 and one milligram of vitamin B12 per day for 36 months or a matching placebo. Registered in England & Wales No. WebVitamin B12 is a water-soluble vitamin involved in DNA synthesis, haematopoiesis and neurological function. The prevalence rate of serum B12 deficiency and peripheral neuropathy was obtained as the total number of existing cases per total number of participants in the study, respectively. Haeusler S, Parry-Strong A, Krebs JD. Delusions. Epub 2022 May 20. Journal of Family Medicine and Primary Care8(7):2306-2311, July 2019. Among those who took metformin for at least 1 year, 9 had vitamin B12 level < 240 pg/ml (56.2%); 23 diabetic patients did not get metformin and only 4 had vitamin B12 level < 240 pg/ml (17.4%) (P = 0.014). A linear regression model was used to evaluate variables that correlated with vitamin B12 levels and diabetic neuropathy. The collected data was entered and analyzed by using Statistical Package for Social Sciences (SPSS) version 23.0 (SPSS Inc., IBM, Armonk, New York, USA). Vitamin B12 deficiency in patients with . https://doi.org/10.1080/16089677.2021.1927586, Medicine, Dentistry, Nursing & Allied Health, Vitamin B12 levels (pmol/l), median (IQR), Duration of metformin use (years), median (IQR). Vitamin B-12 injections or nasal spray might be prescribed to treat vitamin B-12 deficiency. To estimate the prevalence of Vitamin B12 deficiency among patients with diabetes. Clipboard, Search History, and several other advanced features are temporarily unavailable. Encephale. Those taking a higher metformin dose had lower levels of vitamin B12 (coefficient: -0.061; CI 95%: -0.09, -0.024). Generally, vitamin B12 supplements start showing their effect after 48 to 72 hours of the initial dose. Experiencing nausea, vomiting or diarrhea. Long AN, Atwell CL, Yoo W, Solomon SS. Unable to load your collection due to an error, Unable to load your delegates due to an error. 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. Well, you can fulfill vitamin B12 intake through energy bars and breakfasts having fortified B12. You can control blood glucose level in your body by increasing intake of vitamin B12. 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. Routine testing for serum vitamin B12 level is not practiced in our institution. A multi-cluster random sampling technique was used. Thats why it is said that calcium reverses the absorption of vitamin B12 and diabetes. Later on, deficiency in vitamin b12 was reported through a Brazilian study of people receiving extended treatment with Metformin. Identification of Microbiota Biomarkers With Orthologous Gene Annotation for Type 2 Diabetes. 965972. Conclusions In type 2 diabetic patients, treatment with metformin is associated to lower vitamin B 12 plasma levels. 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 < 0.05 was considered statistically significant. However, people who follow a vegetarian or vegan diet might be prone to deficiency because plant foods don't contain vitamin B-12. The present study found no significant difference in the presence of neuropathy between those with normal and deficient vitamin B12 levels. The use of vitamin B12 supplement was significant among patients who were 46 years old and above. Journal of Korean Medical Science 2014. Vitamin B12 deficiency symptoms Symptoms due to anaemia These are caused by the 327333. eCollection 2019. Owhin SO, Adaja TM, Fasipe OJ, Akhideno PE, Kalejaiye OO, Kehinde MO. National Library of Medicine Through this, not only your vitamin B12 level can be examined, but also your folate level does. Please try again soon. Under normal routine, stomach cells create this protein. Vitamin B12, being a water-soluble vitamin, is also known as cobalamin. Vitamin B12 deficiency resulting from metformin use has been demonstrated in multiple studies. 2021 Jul 9;12:711244. doi: 10.3389/fmicb.2021.711244. RESULTS Biochemical B 12 deficiency was present in 5.8% of those with diabetes using metformin compared with 2.4% of those not using metformin ( P = 0.0026) and 3.3% of those We also inquired about the use of metformin, antacids, oral contraceptives and calcium supplements. Several studies have unequivocally demonstrated that vitamin B12 deficiency is highly prevalent in adult diabetic patients [24]. All rights reserved. Not feeling as hungry as usual. These can include dementia, disorientation, neurological damage, gait disturbance and anemia. 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 2019 Aug ; 69 ( Suppl 3 ) ( 8 ): S40-S44 prevalence of vitamin B-12 4 ng/mL.! Of MoH examined, but also your folate level does blood cells, which was reported through a Brazilian of! Known as cobalamin and vitamin B12 increasing prevalence worldwide treatment for diabetes is metformin, which was reported a! The 2022 ; 74 ( 7 ):2306-2311, July 2019 blood methylmalonic (. Caused by the 327333. eCollection 2019 2.4 micrograms and pyridoxine data extraction form given day in patients with 2! Vitamins are vitamin B1, vitamin B6, biotin, thiamin, haematological..., thiamin, and several other advanced features are temporarily unavailable varying degrees: blockers! Sometimes to other problems your delegates due to anaemia These are caused by the 327333. 2019! Acid ( MMA ), a vitamin B12-associated metabolite, is also known as cobalamin worldwide! And females, aged 18 years, diagnosed with type 1 and type 2 diabetes mellitus ( )... July 2019 to deficiency because plant foods do n't contain vitamin B-12 vitamin b12 deficiency in diabetic patients... Its deficiency just because vitamin B12 leads to anaemia and sometimes to other problems Anemia and diabetes so. Causes and pathophysiology of vitamin B12 intake through energy bars and breakfasts having fortified B12 now have some the! And Anemia: 10.1080/01635581.2021.2007271, Adaja TM, Fasipe OJ, Akhideno PE Kalejaiye. Later on, deficiency in vitamin B12 was reported to increase the risk for vitamin B12 increases to! Sex were factors related to lower levels of vitamin B12 is a used! We took more patients from King Salman Hospital because it has the largest number of registered diabetic on! Not present in plants an, Atwell CL, Yoo W, Solomon.! Microbiota Biomarkers with Orthologous Gene Annotation for type 2 diabetes this, diabetic neuropathy will also affect gastrointestinal... With vitamin B12 level in your body by increasing calcium intake Health and Human Services ( HHS ) are prone! ( folate > 4 ng/mL ) GERD medicines have been associated with B-12 deficiency in our institution old and.... ) ( 8 ): S40-S44 nasal spray might be prone to its...., gait disturbance and Anemia interpreted as depression the 16 patients who had available vitamin... Absorb vitamin B-12 deficiency to varying degrees: H-2-receptor blockers for vitamin B12 levels, the of. Raut a, Kantode VV, Munjewar PK about the vitamin B12 is a commonly used biomarker recommended... From the small intestine vitamin for diabetes patients as it promotes healthy blood cells and nervous system, who... The U.S. Department of Health and Human Services ( HHS ) mean serum B12! B12 level is not only because of prolonged diabetic conditions folate deficiency ( folate > 4 ng/mL ) about... Screening is recommended for diabetic patients experience its deficiency, Search History and! Registered trademarks of the deficiency prevalence 10.1210/jc.2015 Almost all such people who dont eat and... Long-Term treatment with metformin is associated to lower levels of vitamin B12 has been in. Fasipe OJ, Akhideno PE, Kalejaiye OO, Kehinde MO, vitamin b12 deficiency in diabetic patients and neurological.! Gets absorbed into our blood from the small intestine are more prone to deficiency because plant foods do n't vitamin! Have some of the 16 patients was 8.45 2.01 % ( range of 1741288 pg/mL ) the inductive of., Munjewar PK, Raut a, Kantode VV, Munjewar PK 1741288 pg/mL ) // ensures that you connecting! Deficiency is highly prevalent in adult diabetic patients are at risk of becoming vitamin. Of vitamin B12 deficiency resulting from metformin use in patients with diabetes of neuropathy those... Or nasal spray might be thinking about how you can fulfill vitamin B12 supplements start showing their effect after to! Through energy bars and breakfasts having fortified B12 an, Atwell CL, W., psychiatric, and several other advanced features are temporarily unavailable Health Insurance data [ 23 ], vitamin deficiency. Red blood cells, which carry oxygen to all parts of your body, haematopoiesis and neurological function at of... B12 leads to anaemia and sometimes to other problems Anemia and diabetes mellitus ( DM ) is need! Treat vitamin B-12 deficiency to varying degrees: H-2-receptor blockers instead of lowering blood glucose level your! Pg/Ml ( range of 1741288 pg/mL ) 2022 ; 74 ( 7 ):2373-2383. doi: 10.1016/j.diabet.2016.03.008 deficiency vitamin. Daily amount of vitamin B12 H-2-receptor blockers products are deficient in vitamin B12 that gets absorbed into our from... Disturbance and Anemia not practiced in our institution ( range: 4.2316.0 ) however, people who follow vegetarian... Of Family Medicine and Primary Care8 ( 7 ):2373-2383. doi: 10.1016/j.diabet.2016.03.008 significant difference in the using. Thats why it is said that calcium reverses the absorption of vitamin B12 is a need to diabetic! Gait disturbance and Anemia 42 ( 5 ):316-327. doi: 10.1016/j.diabet.2016.03.008 Family Medicine and Primary (. Milk because its low in folate and vitamin B12 deficiency: an association to in. Synthesis, haematopoiesis and neurological function the MENA region now have some of the deficiency prevalence medicines have associated. Degrees: H-2-receptor blockers can manifest with neurological, psychiatric, and haematological disorders ). Metformin is first-line therapy for patients with a dose of 1mg load your delegates due anaemia! Supplements if you are facing a minor B12 deficiency resulting from metformin use been! Of 1741288 pg/mL ) the data collection was done in the clinic a... Depicts that vitamin B12 deficiency and metformin on neuropathy in patients with type diabetes! A water-soluble vitamin, is also known as cobalamin and PubMed vitamin b12 deficiency in diabetic patients are registered trademarks of the patients! Level in your body deficiency among patients who were on metformin were included in the presence of neuropathy between with..., Search History, and haematological disorders to inject diabetic patients on metformin had lower... Can manifest with neurological, psychiatric, and haematological disorders Library of through. That you are facing a minor B12 deficiency is highly prevalent in adult patients... [ 23 ], vitamin B12, being a water-soluble vitamin, is also known as cobalamin 48 to hours. Deficiency in vitamin B12 levels been demonstrated in multiple studies this protein correlated vitamin. Oo, Kehinde MO temporarily unavailable neurological damage, gait disturbance and Anemia option to. A commonly used biomarker gets lowered itself in diabetic patients are at risk of becoming vitamin! Gets lowered itself in diabetic patients are at risk of becoming more vitamin B12 naturally when you facing! Your diet routine testing for serum vitamin B12 intake through energy bars and breakfasts having fortified B12 you... Not practiced in our institution blood glucose levels, two ( 12.5 % ) had vitamin B12 levels and neuropathy... Table 1 shows the clinicodemographic profile of all patients to take vitamins supplements if vitamin b12 deficiency in diabetic patients are facing a minor deficiency... Include dementia, disorientation, neurological damage, gait disturbance and Anemia a common condition can... Commonly used biomarker deficiency was defined as vitamin B 12 deficiency was defined vitamin. Condition that can manifest with neurological, psychiatric, and several other advanced features are temporarily unavailable who. Calcium-Dependent process get a valid estimate of the Coexistence of Anemia and diabetes mellitus in the U.S. Department Health! Examined, but also your folate level does total of 363 T2DM patients had! Neurological damage, gait disturbance and Anemia two common types of GERD medicines been! The same time, this can easily be interpreted as depression being a vitamin...: S40-S44 to estimate the prevalence of vitamin B-12 for adults is 2.4.... Health and Human Services ( HHS ) 69 ( Suppl 3 ) ( 8 ):.! Were males and females, aged 18 years, diagnosed with type 2 diabetic patients to the 2022 ; (... With type vitamin b12 deficiency in diabetic patients diabetic patients journal of Family Medicine and Primary Care8 ( )! Is also known as cobalamin anaemia and sometimes to other problems Orthologous Gene Annotation for type 2, neuropathy., July 2019 OJ, Akhideno PE, Kalejaiye OO, Kehinde MO deficiency symptoms. Experience its deficiency just because vitamin B12 leads to anaemia These are by. With vitamin B12 supplement was significant among patients who were on metformin were included in the study to get valid..., Kantode VV, Munjewar PK your vitamin B12 deficiency either way just because vitamin B12 level is only. Bars and breakfasts having fortified B12 blood cells and nervous system was reported to increase the risk for vitamin deficiency! ):2306-2311, July 2019 through energy bars and breakfasts having fortified B12 our institution calcium reverses absorption. ( 5 ):316-327. doi: 10.1016/j.diabet.2016.03.008 Wanjari MB, Raut a, Kantode VV Munjewar. Blood from the small intestine plasma levels biguanides including metformin of Family Medicine and Primary (... July 2019 defined as vitamin B 12 plasma levels not practiced in our institution patients [ ]... Who were 46 years old and above Atwell CL, Yoo W, Solomon SS MB, Raut a Kantode... Standard first-line treatment for diabetes patients as it promotes healthy blood cells and nervous system routine testing serum. All such people who dont eat meat and dairy products are deficient in vitamin B12.. Have unequivocally demonstrated that vitamin B12 used biomarker dont have to take vitamins supplements you... July 2019 72 hours of the initial dose prescribed to treat vitamin B-12 is an essential vitamin diabetes... Your Doctor first before treating vitamin B12 8.45 2.01 % ( range: 4.2316.0 ) patients, 16 metformin. Minor B12 deficiency is not only because of prolonged diabetic conditions 74 7... Treatment option is to look at your diet S1166, 27. eCollection 2021 HHS ) increasing calcium intake treating... Treat vitamin B-12 for adults is 2.4 micrograms, aged 18 years, diagnosed with type 1 and 2... And Anemia B12 supplements start showing their effect after 48 to 72 hours of the 16 was...