Cobalamin status and its relation with depression, cognition and neuropathy in patients with type 2 diabetes mellitus using metformin

Biemans, Elke; Hart, Huberta E.; Rutten, Guy E.H.M.; Renteria, Viviana G. Cuellar; Kooijman-Buiting, Antoinette M. J.; Beulens, Joline W.J.

doi:10.1007/s00592-014-0661-4

Cited by 38 publications

(28 citation statements)

References 27 publications

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“…Other studies have demonstrated a close association between vitamin B 12 deficiency and long term use and high dose metformin therapy [3–6, 11, 13, 23]. Metformin has been shown to reduce calcium bioavailability which affects ileal vitamin B12 absorption [1, 24].…”

Section: Discussionmentioning

confidence: 99%

Vitamin B12 deficiency among adult diabetic patients in Uganda: relation to glycaemic control and haemoglobin concentration

Akabwai

Kibirige²,

Mugenyi

et al. 2015

J Diabetes Metab Disord

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BackgroundVitamin B12 deficiency is highly prevalent among adult individuals with diabetes yet screening is infrequent in Uganda. There are currently no published data regarding the prevalence of vitamin B12 deficiency and its associated factors among adult individuals with diabetes in sub-Saharan Africa. This study aimed at describing the prevalence and factors associated with vitamin B12 deficiency among this patient population in a resource constrained setting in sub-Saharan Africa.MethodsIn this cross-sectional study, 280 eligible study participants attending the outpatient diabetic clinic at Mulago national referral and teaching hospital in Kampala, Uganda were enrolled. Their socio-demographic, clinical and laboratory data was collected using a pre-tested questionnaire.ResultsThe majority of the study participants were female (68.9 %), with a median age of 50 (IQR: 40–58) years. The mean (SD) serum vitamin B12 levels was 472.0 (16.4) pg/ml. The prevalence of vitamin B12 deficiency was 10.7 %. Hemoglobin level < 12 g/dl (AOR 3.38; 95 % CI 1.38–8.32, p value = 0.008) and glycated hemoglobin ≥ 7 % (AOR 3.29; 1.44–7.51, p value = 0.005) were associated with vitamin B12 deficiency.ConclusionsVitamin B12 deficiency is prevalent in approximately 1 in 10 of adult individuals with diabetes in Uganda. We recommend screening for vitamin B12 deficiency among diabetic patients in Uganda especially those with low hemoglobin concentrations and glycated hemoglobin levels ≥ 7 %.

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Section: Discussionmentioning

confidence: 99%

Vitamin B12 deficiency among adult diabetic patients in Uganda: relation to glycaemic control and haemoglobin concentration

Akabwai

Kibirige²,

Mugenyi

et al. 2015

J Diabetes Metab Disord

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“…Two recent studies reported that the vitamin deficiency among metformin-treated patients was associated with worsened cognitive performance and increased risk of depression (107,110).…”

Section: Neuropsychiatric Manifestationsmentioning

confidence: 99%

“…Biemans et al (107) Four primary care centers, the Netherlands Cross-sectional study. Metformintreated T2DM patients were divided into vitamin B12-deficient and normal groups.…”

Section: Dementioning

confidence: 99%

Metformin and Vitamin B12 Deficiency: Where Do We Stand?

Ahmed

2016

J Pharm Pharm Sci

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-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.

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“…Separately, metformin, which is commonly used to decrease insulin resistance in T2D, has been suggested to have a side effect that results in the inhibition of vitamin‐B 12 absorption in the digestive tract through a mechanism completely different from that suggested for H pylori . Thus, in the guidelines for the treatment of diabetes, T2D patients using metformin have been recommended to check their serum vitamin‐B 12 levels regularly and use vitamin‐B 12 supplements when necessary 8,25 . This study examined the H pylori infection status and vitamin‐B 12 levels in T2D patients receiving metformin treatment and found that the mean serum vitamin‐B 12 level was significantly lower and the rate of vitamin‐B 12 deficiency was significantly higher in diabetic patients with H pylori infection compared to those without H pylori infection.…”

Section: Discussionmentioning

confidence: 99%

The role of Helicobacter pylori in vitamin‐B₁₂ deficiency due to metformin use

Gökışık¹,

Uyar²

2020

Helicobacter

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Background Metformin is widely used for the treatment of type‐2 diabetes (T2D) but was shown to cause vitamin‐B12 deficiency. H pylori infection was also suggested to cause vitamin‐B12 deficiency. This study aimed to elucidate the relationships in this triad by investigating vitamin‐B12 deficiency and H pylori infection in T2D patients using metformin. Materials and Methods This descriptive cross‐sectional study recruited T2D patients using metformin from a primary care center and examined their socioeconomic status, accompanying complaints, medication use, and hemogram parameters such as serum vitamin B12, calcium, and hemoglobin. The presence of H pylori infection was determined through stool antigen test. Results Study included 421 T2D patients on metformin regimen: 213 (50.6%) males and 208 (49.4%) females. The mean duration of diabetes was 9.88 ± 7.32 years, and the total metformin dose was 1925.5 ± 236.7 mg/d. Almost half of the participants (n = 199, 47.3%) had H pylori infection, and more than half (n = 222, 52.7%) had vitamin‐B12 deficiency. The rate of vitamin‐B12 deficiency was significantly higher among those with H pylori infection. No significant relationship was found between the daily metformin dose and vitamin‐B12 deficiency. Conclusions This study supported the role of H pylori infection in vitamin‐B12 deficiency. However, the effects of increased metformin dose and H pylori infection on vitamin‐B12 levels were not additive. It is recommended that vitamin‐B12 levels in T2D patients are monitored and those with vitamin‐B12 deficiency, regardless of metformin dose, are screened for H pylori and, if necessary, treated.

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Cobalamin status and its relation with depression, cognition and neuropathy in patients with type 2 diabetes mellitus using metformin

Cited by 38 publications

References 27 publications

Vitamin B12 deficiency among adult diabetic patients in Uganda: relation to glycaemic control and haemoglobin concentration

Vitamin B12 deficiency among adult diabetic patients in Uganda: relation to glycaemic control and haemoglobin concentration

Metformin and Vitamin B12 Deficiency: Where Do We Stand?

The role of Helicobacter pylori in vitamin‐B₁₂ deficiency due to metformin use

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Cobalamin status and its relation with depression, cognition and neuropathy in patients with type 2 diabetes mellitus using metformin

Cited by 38 publications

References 27 publications

Vitamin B12 deficiency among adult diabetic patients in Uganda: relation to glycaemic control and haemoglobin concentration

Vitamin B12 deficiency among adult diabetic patients in Uganda: relation to glycaemic control and haemoglobin concentration

Metformin and Vitamin B12 Deficiency: Where Do We Stand?

The role of Helicobacter pylori in vitamin‐B12 deficiency due to metformin use

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Product

Resources

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The role of Helicobacter pylori in vitamin‐B₁₂ deficiency due to metformin use