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Metformin B12 Deficiency Pubmed

The Role Of Metformin On Vitamin B12 Deficiency: A Meta-analysis Review.

The Role Of Metformin On Vitamin B12 Deficiency: A Meta-analysis Review.

1. Intern Emerg Med. 2015 Feb;10(1):93-102. doi: 10.1007/s11739-014-1157-5. Epub2014 Dec 13. The role of metformin on vitamin B12 deficiency: a meta-analysis review. Niafar M(1), Hai F, Porhomayon J, Nader ND. (1)Tabriz University of Medical Sciences, Bone Research Center, Tabriz, Iran. Metformin is the only biguanide oral hypoglycemic drug, that is used to treatpatients with type-2 diabetes mellitus. There are some reports of metformin beingassociated with decreased serum levels of vitamin B12 (VB12). The objective ofthis study is to systematically analyze the impact of metformin on the frequency of VB12 deficiency and serum levels of VB12. A search of various databasesprovided 18 retrospective cohort studies and 11 randomized controlled trials.Pooled estimates of odds ratio with 95% confidence interval using random effectmodel were conducted. Studies were examined for heterogeneity, publication biasand sensitivity analysis. Separate analysis of randomized control trials (RCTs)including both low-risk and high-risk bias was also conducted. 29 studies wereselected with a total of 8,089 patients. 19 studies were rated intermediate orhigh quality. Primary outcome suggested increased incidence of VB12 deficiency inmetformin group (OR = 2.45, 95% CI 1.74-3.44, P < 0.0001.) Heterogeneity wasrelatively high (I(2) = 53%), with minor publication bias. Secondary outcomesuggested lower serum VB12 concentrations in metformin group (Mean difference =-65.8, 95% CI -78.1 to -53.6 pmol/L, P < 0.00001) with high heterogeneity (I(2) =98%,) and low publication bias. RCTs analysis of low-and high-risk group revealedsimilar trends. We conclude that metformin treatment is significantly associated with an increase in incidence of VB12 deficiency and reduced serum VB12 levels. Continue reading >>

Long Term Treatment With Metformin In Patients With Type 2 Diabetes And Risk Of Vitamin B-12 Deficiency: Randomised Placebo Controlled Trial

Long Term Treatment With Metformin In Patients With Type 2 Diabetes And Risk Of Vitamin B-12 Deficiency: Randomised Placebo Controlled Trial

Long term treatment with metformin in patients with type 2 diabetes and risk of vitamin B-12 deficiency: randomised placebo controlled trial Long term treatment with metformin in patients with type 2 diabetes and risk of vitamin B-12 deficiency: randomised placebo controlled trial BMJ 2010; 340 doi: (Published 20 May 2010) Cite this as: BMJ 2010;340:c2181 Philippe Lehert, professor of statistics 4 , Michiel G Wulffel, general practitioner 2 3 , Jan van der Kolk, biochemical engineer 5 , Joop Verburg, chief laboratory attendant 5 , Ab J M Donker, professor of internal medicine 7 , Coen D A Stehouwer, professor and chair 8 1Department of Ophthalmology, Academic Medical Center, Amsterdam, Netherlands 2Bethesda Diabetes Research Centre, Bethesda General Hospital, Hoogeveen, Netherlands 3Department of Internal Medicine, Bethesda General Hospital, Hoogeveen, Netherlands 4Department of Statistics, Faculty of Economics, Facults Universitaires Catholiques de Mons, Louvain Academy, Mons, Belgium 5Clinical Laboratory, Bethesda General Hospital, Hoogeveen, Netherlands 6Clinical Research and Development, Merck Netherlands, Amsterdam, Netherlands 7Department of Internal Medicine, Free University Medical Center, Amsterdam, Netherlands 8Department of Internal Medicine, Maastricht University Medical Centre, Maastricht, Netherlands Correspondence to: C D A Stehouwer cda.stehouwer{at}mumc.nl Objectives To study the effects of metformin on the incidence of vitamin B-12 deficiency (<150 pmol/l), low concentrations of vitamin B-12 (150-220 pmol/l), and folate and homocysteine concentrations in patients with type 2 diabetes receiving treatment with insulin. Design Multicentre randomised placebo controlled trial. Setting Outpatient clinics of three non-academic hospitals in the Netherlands. P Continue reading >>

Vitamin B12 Deficiency Associated With Metformin

Vitamin B12 Deficiency Associated With Metformin

Vitamin B12 Deficiency Associated With Metformin Metformin is the only biguanide that is currently in use as an oral hypoglycemic in type II (noninsulin dependent) patients with diabetes. Like all hypoglycemic medications, metformin is not to be taken without careful analysis of associated risks. Lactic acidosis is the most studied and feared side effect; however, vitamin B12 (cobalamin) malabsorption is an underappreciated side effect in up to 30% of patients on metformin (Glucophage Label and Approval History. US Food and Drug Administration. Accessed October 1, 2008). The goal of this article is to examine the role of metformin in cobalamin deficiency, as well as outline the steps that are necessary to assess the incidence of B12 deficiency and its potential reversal with calcium supplementation in a clinical setting. *4th-yr Medical Student, the University of New England, Biddeford, ME. Chief Editor's Note: This article is the 2nd of 18 that will be published in 2010 for which a total of up to 18 AMA PRA Category 1 Credits can be earned. Instructions for how credits can be earned precede the CME Examination at the back of this issue. Unless otherwise noted below, each faculty's spouse/life partner (if any) has nothing to disclose. The authors have disclosed that they have no significant relationships with or financial interests in any commercial organizations pertaining to this educational activity. All staff in a position to control the content of this CME activity have disclosed that they have no financial relationships with, or financial interests in, any commercial companies pertaining to this educational activity. Reprints: Sahil Parikh, MSIV, Hills Beach Road, Biddeford, ME 04005. E-mail: [email protected] 2010 Lippincott Williams & Wilkins, Inc. Thought Continue reading >>

Is Metformin-induced Vitamin B12 Deficiency Responsible For Cognitive Decline In Type 2 Diabetes?

Is Metformin-induced Vitamin B12 Deficiency Responsible For Cognitive Decline In Type 2 Diabetes?

Is Metformin-Induced Vitamin B12 Deficiency Responsible for Cognitive Decline in Type 2 Diabetes? Department of Physiology, University College of Medical Sciences, New Delhi, India 1Department of Endocrinology and Metabolism, University College of Medical Sciences, New Delhi, India Address for correspondence: Dr. Deepti Khattar Department of Physiology, University College of Medical Sciences, New Delhi - 110 095, India. E-mail: [email protected] Author information Copyright and License information Disclaimer Copyright : 2016 Indian Psychiatric Society This is an open access article distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 3.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as the author is credited and the new creations are licensed under the identical terms. This article has been cited by other articles in PMC. Diabetes mellitus has its deleterious effects on various aspects of cognition such as memory function, executive function, and information-processing speed. The present study aims to assess cognition in diabetes patients and also tries to find its association with Vitamin B12 deficiency induced by metformin. Thirty diabetics taking metformin and thirty nondiabetic controls were enrolled. Event-related potentials (ERPs) and serum Vitamin B12 levels were evaluated in them. Vitamin B12 levels were found to be deficient, and latencies of waves P200 and P300 were prolonged in the diabetics as compared to the controls. The dose and duration of metformin had no association with the ERPs. Although the Vitamin B12 levels were deficient in diabetics on metformin, this is not the reason behind the cognitive impairment found in them. Key words: Cognition, event-related pot Continue reading >>

Vitamin B12 Deficiency In Metformin-treated Type-2 Diabetes Patients, Prevalence And Association With Peripheral Neuropathy

Vitamin B12 Deficiency In Metformin-treated Type-2 Diabetes Patients, Prevalence And Association With Peripheral Neuropathy

Vitamin B12 deficiency in metformin-treated type-2 diabetes patients, prevalence and association with peripheral neuropathy 1Department of Pharmacology, Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa 2Department of Internal Medicine, Steve Biko Academic Hospital, University of Pretoria, Pretoria, South Africa Marwan A. Ahmed, Email: [email protected] . Received 2016 Apr 23; Accepted 2016 Sep 7. Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License ( ), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver ( ) applies to the data made available in this article, unless otherwise stated. This article has been cited by other articles in PMC. The association between long-term metformin use and low vitamin B12 levels has been proven. However, the prevalence estimates of metformin-induced vitamin B12 deficiency showed considerable variation among the studies. The potential of the deficiency to cause or worsen peripheral neuropathy in type-2 diabetes mellitus (T2DM) patients has been investigated with conflicting results. The aim of the study was to investigate: 1) the prevalence of vitamin B12 deficiency in T2DM patients on metformin; 2) the association between vitamin B12 and peripheral neuropathy; 3) and the risk factors for vitamin B12 deficiency in these patients. In this cross-sectional study, consecutive metformin-treated T2DM patients attending diabetes clinics of two public hospitals in South Africa were approached for participation. Participati Continue reading >>

Prime Pubmed | Metformin And Vitamin B12 Deficiency: Where Do We Stand?

Prime Pubmed | Metformin And Vitamin B12 Deficiency: Where Do We Stand?

Type your tag names separated by a space and hit enter Metformin and Vitamin B12 Deficiency: Where Do We Stand? The association between metformin use and low vitamin B12 levels in type 2 diabetes mellitus patients is well-established. However, many aspects of the topic remain to be elucidated. There is still controversy on the current diagnostic approaches to vitamin B12 deficiency. It is now believed that measuring the serum levels of the vitamin may not reflect its metabolic status. Moreover, there were conflicting results from studies attempting to quantify and explore metformin-associated vitamin B12 deficiency and its clinical impacts. This article reviews the cellular functions of vitamin B12, the biomarkers utilized to define the vitamin deficiency and metformin-induced vitamin B12 deficiency with an emphasis on its prevalence and clinical impacts.This article is open to POST-PUBLICATION REVIEW. Registered readers (see "For Readers") may comment by clicking on Department of Pharmacology, Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa. Ahmed MA: "Metformin and Vitamin B12 Deficiency: Where Do We Stand?" Journal of pharmacy & pharmaceutical sciences : a publication of the Canadian Society for Pharmaceutical Sciences, Societe canadienne des sciences pharmaceutiques, vol. 19, no. 3, 2016 Jul - Sep, pp. 382-398, Accessed June 27, 2018. Ahmed MA. Metformin and Vitamin B12 Deficiency: Where Do We Stand? J Pharm Pharm Sci 2016 Jul - Sep;19(3):382-398 Accessed June 27, 2018. Ahmed MA. (2016 Jul - Sep). Metformin and Vitamin B12 Deficiency: Where Do We Stand? Journal of pharmacy & pharmaceutical sciences : a publication of the Canadian Society for Pharmaceutical Sciences, Societe canadienne des sciences pharmaceutiques, 19, pp. 382-398. doi:10. Continue reading >>

Relationship Between Metformin Use, Vitamin B12 Deficiency, Hyperhomocysteinemia And Vascular Complications In Patients With Type 2 Diabetes.

Relationship Between Metformin Use, Vitamin B12 Deficiency, Hyperhomocysteinemia And Vascular Complications In Patients With Type 2 Diabetes.

1. Endocr J. 2013;60(12):1275-80. Epub 2013 Sep 8. Relationship between metformin use, vitamin B12 deficiency, hyperhomocysteinemia and vascular complications in patients with type 2 diabetes. Sato Y(1), Ouchi K, Funase Y, Yamauchi K, Aizawa T. (1)Diabetes Center, Aizawa Hospital, Matsumoto, Japan. Aim of the study was to clarify the relationship between metformin-inducedvitamin B12 (B12) deficiency, hyperhomocysteinemia and vascular complications in patients with type 2 diabetes. Serum B12 concentrations, homocysteine plasmalevels, the presence of retinopathy and history of macroangiopathy (stroke orcoronary heart disease) were analyzed in patients without renal dysfunction(serum creatinine<115 mol/L). Firstly, B12 status was analyzed in 62 consecutivemetformin-treated patients. Secondly, the relationship between B12, homocysteine and vascular complications was analyzed in 46 metformin-treated and 38 age- andsex-matched non-metformin-treated patients. Among the 62 consecutivemetformin-treated patients, B12 was deficient (<150 pmol/L) in 8 (13%) andborderline-deficient (150-220 pmol/L) in 18 (29%): the larger the metformindosage, the lower the B12 (P=0.02, Spearman's =-0.30). There were independentcorrelations between metformin use and B12 lowering (P=0.02, r = -0.25), and B12 lowering and elevation of homocysteine (P<0.01, r=-0.34). Elevation ofhomocysteine was a risk for retinopathy (P=0.02, OR 1.26, 95%CI 1.04-1.52). Therewas no significant relation between homocysteine and macroangiopathy. Correlationbetween B12 and homocysteine was stronger in metformin-treated (P<0.01, r=-0.48) than non-metformin-treated (P=0.04, r=-0.38) patients. In ten B12 deficientpatients, B12 supplementation (1,500 g/day) for 2.21.0 months with continueduse of metformin raised B12 levels: 1 Continue reading >>

Study Of Vitamin B 12 Deficiency And Peripheral Neuropathy In Metformin-treated Early Type 2 Diabetes Mellitus Roy Rp, Ghosh K, Ghosh M, Acharyya A, Bhattacharya A, Pal M, Chakraborty S, Sengupta N - Indian J Endocr Metab

Study Of Vitamin B 12 Deficiency And Peripheral Neuropathy In Metformin-treated Early Type 2 Diabetes Mellitus Roy Rp, Ghosh K, Ghosh M, Acharyya A, Bhattacharya A, Pal M, Chakraborty S, Sengupta N - Indian J Endocr Metab

Diabetes mellitus (DM) is associated with risk of cardiovascular diseases, which cannot be fully justified by important risk factors such as hyperglycemia, [1] hypertension, [2] and dyslipidemia. [3] Among all risk factors, homocysteine (Hcy) is recognized as an independent, [4] and potentially modifiable, [5] risk factor that may be strongly linked to cardiovascular prognosis in Type 2 diabetes. [6] It can also be a determinant of microalbuminuria and diabetic retinopathy. Hcy is produced during the demethylation of methionine. It is normally metabolized by two pathways, remethylation and transsulfuration. Remethylation acts as a catalyst for methionine synthase. In this reaction, 5-methyltetrahydrofolate is a methyl group donor and Vitamin B 12 is a cofactor. Several studies found decreased serum Vitamin B 12 level among metformin-treated diabetes patients [7] probably due to malabsorption. [8] Hence, during metformin treatment, Hcy level might increase, but data on this issue are contradictory. [9] , [10] With this idea in mind, we conducted a study at B.R. Singh Hospital, Kolkata, among the Type 2 diabetic patients who are on metformin for at least 2 years but not more than 3 years after they were first detected with diabetes and compared them with patients not on metformin for the same duration. The effects of metformin treatment on serum levels of Hcy, Vitamin B 12 and folate level in patients with Type 2 diabetes were studied. To study the blood level of Vitamin B 12 , folic acid, and Hcy in metformin-treated early Type 2 DM To study the evidence of peripheral neuropathy in metformin-treated early Type 2 DM. A hospital-based, comparative, descriptive study was conducted in the Department of Medicine, B.R. Singh Hospital, Kolkata, during August 2010-June 2012. A Continue reading >>

Metformin Use And Vitamin B12 Deficiency: Untangling The Association.

Metformin Use And Vitamin B12 Deficiency: Untangling The Association.

Metformin Use and Vitamin B12 Deficiency: Untangling the Association. Rodrguez-Gutirrez R, et al. Am J Med Sci. 2017. Knowledge and Evaluation Research Unit in Endocrinology, Department of Medicine, Mayo Clinic, Rochester, Minnesota; Department of Medicine, Mayo Clinic, Rochester, Minnesota. Division of Endocrinology, Internal Medicine Department, University Hospital "Dr. Jos E. Gonzlez", Universidad Autonoma de Nuevo Leon, Monterrey, Nuevo Leon, Mexico. Internal Medicine Department, University Hospital "Dr. Jos E. Gonzlez", Universidad Autonoma de Nuevo Leon, Monterrey, Nuevo Leon, Mexico. Division of Endocrinology, Internal Medicine Department, University Hospital "Dr. Jos E. Gonzlez", Universidad Autonoma de Nuevo Leon, Monterrey, Nuevo Leon, Mexico. Electronic address: [email protected] Am J Med Sci. 2017 Aug;354(2):165-171. doi: 10.1016/j.amjms.2017.04.010. Epub 2017 Jul 8. BACKGROUND: Current evidence linking vitamin B12 deficiency with metformin use is inconsistent. Hence, there is uncertainty regarding the diagnostic approach in this scenario. Furthermore, this possible association has not been studied in the complete spectrum of patients with diabetes. MATERIALS AND METHODS: We conducted a cross-sectional, controlled study with the objective of assessing differences in serum vitamin B12 levels among patients with and without diabetes with different metformin-treatment regimens. A total of 150 participants were recruited: patients with diabetes (group 1: metformin alone 850mg/day, group 2: patients with type 2 diabetes naive to treatment and group 3: metformin 850mg/day, in addition to any other oral glucose lowering agent or insulin, or both) and without diabetes (group 4: polycystic ovary syndrome or group 5: healthy individuals). Serum vitamin B12, folat Continue reading >>

Metformin And Vitamin B12 Deficiency: Where Do We Stand?

Metformin And Vitamin B12 Deficiency: Where Do We Stand?

1. J Pharm Pharm Sci. 2016 Jul - Sep;19(3):382-398. doi: 10.18433/J3PK7P. Metformin and Vitamin B12 Deficiency: Where Do We Stand? (1)Department of Pharmacology, Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa. The association between metformin use and low vitamin B12 levels in type 2diabetes mellitus patients is well-established. However, many aspects of thetopic remain to be elucidated. There is still controversy on the currentdiagnostic approaches to vitamin B12 deficiency. It is now believed thatmeasuring the serum levels of the vitamin may not reflect its metabolic status.Moreover, there were conflicting results from studies attempting to quantify and explore metformin-associated vitamin B12 deficiency and its clinical impacts.This article reviews the cellular functions of vitamin B12, the biomarkersutilized to define the vitamin deficiency and metformin-induced vitamin B12deficiency with an emphasis on its prevalence and clinical impacts.This article is open to POST-PUBLICATION REVIEW. Registered readers (see "For Readers") maycomment by clicking on ABSTRACT on the issue's contents page. Vitamin B 12 Deficiency/chemically induced* Continue reading >>

Long-term Metformin Use And Vitamin B12 Deficiency In The Diabetes Prevention Program Outcomes Study

Long-term Metformin Use And Vitamin B12 Deficiency In The Diabetes Prevention Program Outcomes Study

Long-term Metformin Use and Vitamin B12 Deficiency in the Diabetes Prevention Program Outcomes Study Vanita R. Aroda , Sharon L. Edelstein , Ronald B. Goldberg , William C. Knowler , Santica M. Marcovina , Trevor J. Orchard , George A. Bray , David S. Schade , Marinella G. Temprosa , Neil H. White , Jill P. Crandall , and the Diabetes Prevention Program Research Group MedStar Health Research Institute (V.R.A.), Hyattsville, Maryland 20782; George Washington University (S.L.E., M.G.T.), Rockville, MD 20852; University of Miami (R.B.G.), Miami, Florida 33146; National Institute of Diabetes and Digestive and Kidney Diseases (W.C.K.), Phoenix, Arizona 85014; University of Washington (S.M.M.), Seattle, Washington 98185; University of Pittsburgh (T.J.O.), Pittsburgh, Pennsylvania 15260; Pennington Biomedical Research Institute (G.A.B.), Baton Rouge, Louisiana 70808; University of New Mexico (D.S.S.), Albuquerque, New Mexico 87131; Washington University School of Medicine (N.H.W.), St. Louis, Missouri 63110; and Albert Einstein College of Medicine (J.P.C.), Bronx, New York 10461 Address all correspondence and requests for reprints to: Jill Crandall, MD, Diabetes Prevention Program Coordinating Center, The Biostatistics Center, The George Washington University, 6110 Executive Boulevard, Suite 750, Rockville, MD 20852. E-mail: [email protected] . Received 2015 Oct 22; Accepted 2016 Feb 17. Copyright 2016 by the Endocrine Society This article has been cited by other articles in PMC. Vitamin B12 deficiency may occur with metformin treatment, but few studies have assessed risk with long-term use. To assess the risk of B12 deficiency with metformin use in the Diabetes Prevention Program (DPP)/DPP Outcomes Study (DPPOS). Secondary analysis from the DPP/DPPOS. Participants were ass Continue reading >>

Long-term Metformin Use And Vitamin B12 Deficiency In The Diabetes Preventionprogram Outcomes Study.

Long-term Metformin Use And Vitamin B12 Deficiency In The Diabetes Preventionprogram Outcomes Study.

1. J Clin Endocrinol Metab. 2016 Apr;101(4):1754-61. doi: 10.1210/jc.2015-3754. Epub2016 Feb 22. Long-term Metformin Use and Vitamin B12 Deficiency in the Diabetes PreventionProgram Outcomes Study. Aroda VR(1), Edelstein SL(1), Goldberg RB(1), Knowler WC(1), Marcovina SM(1),Orchard TJ(1), Bray GA(1), Schade DS(1), Temprosa MG(1), White NH(1), CrandallJP(1); Diabetes Prevention Program Research Group. (1)MedStar Health Research Institute (V.R.A.), Hyattsville, Maryland 20782; George Washington University (S.L.E., M.G.T.), Rockville, MD 20852; University of Miami (R.B.G.), Miami, Florida 33146; National Institute of Diabetes and Digestive and Kidney Diseases (W.C.K.), Phoenix, Arizona 85014; University of Washington (S.M.M.), Seattle, Washington 98185; University of Pittsburgh (T.J.O.), Pittsburgh, Pennsylvania 15260; Pennington Biomedical Research Institute (G.A.B.), Baton Rouge, Louisiana 70808; University of New Mexico (D.S.S.), Albuquerque, New Mexico 87131; Washington University School of Medicine (N.H.W.), St. Louis, Missouri 63110; and Albert Einstein College of Medicine (J.P.C.), Bronx, New York 10461. Comment in Nat Rev Endocrinol. 2016 Jun;12(6):312. CONTEXT: Vitamin B12 deficiency may occur with metformin treatment, but fewstudies have assessed risk with long-term use.OBJECTIVE: To assess the risk of B12 deficiency with metformin use in theDiabetes Prevention Program (DPP)/DPP Outcomes Study (DPPOS).DESIGN: Secondary analysis from the DPP/DPPOS. Participants were assigned to the placebo group (PLA) (n = 1082) or the metformin group (MET) (n = 1073) for 3.2years; subjects in the metformin group received open-label metformin for anadditional 9 years.SETTING: Twenty-seven study centers in the United States.PATIENTS: DPP eligibility criteria were: elevated fasting Continue reading >>

Association Of Vitamin B12 Deficiency And Metformin Use In Patients With Type 2 Diabetes.

Association Of Vitamin B12 Deficiency And Metformin Use In Patients With Type 2 Diabetes.

J Korean Med Sci. 2014 Jul;29(7):965-72. doi: 10.3346/jkms.2014.29.7.965. Epub 2014 Jul 11. Association of vitamin B12 deficiency and metformin use in patients with type 2 diabetes. Division of Endocrinology & Metabolism, Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul, Korea. Department of Biostatistics, College of Medicine, The Catholic University of Korea, Seoul, Korea. Department of Preventive Medicine, College of Medicine, The Catholic University of Korea, Seoul, Korea. ; Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA. We evaluated the prevalence of vitamin B12 deficiency and associated factors in type 2 diabetes patients using metformin. A total of 799 type 2 diabetes patients using metformin was enrolled. Vitamin B12 and folate levels were quantified by chemiluminescent enzyme immunoassay. Vitamin B12 deficiency was defined as vitamin B12 300 pg/mL without folate deficiency (folate > 4 ng/mL). The prevalence of vitamin B12 deficiency in metformin-treated type 2 diabetes patients was 9.5% (n = 76), and the mean vitamin B12 level was 662.5 246.7 pg/mL. Vitamin B12 deficient patients had longer duration of metformin use (P < 0.001) and higher daily metformin dose (P < 0.001) than non-deficient patients. Compared with daily metformin dose of 1,000 mg, the adjusted odds ratio for 1,000-2,000 mg, and 2,000 mg were 2.52 (95% CI, 1.27-4.99, P = 0.008) and 3.80 (95% CI, 1.82-7.92, P < 0.001). Compared with metformin use of < 4 yr, the adjusted odds ratios for 4-10 yr, and 10 yr were 4.65 (95% CI, 2.36-9.16, P < 0.001) and 9.21 (95% CI, 3.38-25.11, P < 0.001), respectively. In conclusion, our study indicates that patients with type 2 diabetes treate Continue reading >>

Association Of Biochemical B12 Deficiency With Metformin Therapy And Vitamin B12 Supplements

Association Of Biochemical B12 Deficiency With Metformin Therapy And Vitamin B12 Supplements

Association of Biochemical B12 Deficiency With Metformin Therapy and Vitamin B12 Supplements The National Health and Nutrition Examination Survey, 19992006 Rollins School of Public Health, Emory University, Atlanta, Georgia Corresponding author: Godfrey P. Oakley Jr., [email protected] . Received 2011 Aug 17; Accepted 2011 Oct 30. Copyright 2012 by the American Diabetes Association. Readers may use this article as long as the work is properly cited, the use is educational and not for profit, and the work is not altered. See for details. This article has been cited by other articles in PMC. To describe the prevalence of biochemical B12 deficiency in adults with type 2 diabetes taking metformin compared with those not taking metformin and those without diabetes, and explore whether this relationship is modified by vitamin B12 supplements. Analysis of data on U.S. adults 50 years of age with (n = 1,621) or without type 2 diabetes (n = 6,867) from the National Health and Nutrition Examination Survey (NHANES), 19992006. Type 2 diabetes was defined as clinical diagnosis after age 30 without initiation of insulin therapy within 1 year. Those with diabetes were classified according to their current metformin use. Biochemical B12 deficiency was defined as serum B12 concentrations 148 pmol/L and borderline deficiency was defined as >148 to 221 pmol/L. Biochemical B12 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 without diabetes (P = 0.0002). Among those with diabetes, metformin use was associated with biochemical B12 deficiency (adjusted odds ratio 2.92; 95% CI 1.266.78). Consumption of any supplement containing B12 was not associated with a reduction in the prevalence o Continue reading >>

Association Between Metformin And Vitamin B12 Deficiency In Patients With Type 2 Diabetes: A Systematic Review And Meta-analysis.

Association Between Metformin And Vitamin B12 Deficiency In Patients With Type 2 Diabetes: A Systematic Review And Meta-analysis.

Generate a file for use with external citation management software. Diabetes Metab. 2016 Nov;42(5):316-327. doi: 10.1016/j.diabet.2016.03.008. Epub 2016 Apr 26. Association between metformin and vitamin B12 deficiency in patients with type 2 diabetes: A systematic review and meta-analysis. Department of Nutritional Sciences, School of Biosciences and Medicine, Faculty of Health and Medical Sciences, University of Surrey, GU2 7XH Guildford, United Kingdom; Ravenscroft Medical Centre, 166-168 Golders Green Road, Golders Green, NW11 8BB London, United Kingdom. Department of Nutritional Sciences, School of Biosciences and Medicine, Faculty of Health and Medical Sciences, University of Surrey, GU2 7XH Guildford, United Kingdom. Electronic address: [email protected] Department of Nutritional Sciences, School of Biosciences and Medicine, Faculty of Health and Medical Sciences, University of Surrey, GU2 7XH Guildford, United Kingdom. Metformin is the most widely used oral hypoglycaemic drug, but it may lower B12 status, which could have important clinical implications. We undertook a systematic review and meta-analysis of the relationship between metformin use and vitamin B12 deficiency in persons with type 2 diabetes. Electronic database searches were undertaken (1st January 1957-1st July 2013) using the Cochrane library, Scopus, CINAHL, Grey literature databases, Pub Med Central, NICE Clinical Guidelines UK, and ongoing clinical trials. Included studies were of any study design, with data from patients with type 2 diabetes of any age or gender, taking any dose or duration of metformin. Planned primary outcomes were serum vitamin B12 levels, % prevalence or incidence of vitamin B12 deficiency and risk of vitamin B12 deficiency. Twenty-six papers were included in the r Continue reading >>

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