Increased intake of calcium reverses vitamin B12 malabsorption induced by metformin.

Bauman, William A.; Shaw, Spencer; Jayatilleke, Elizabeth; Spungen, Ann M.; Herbert, Victor

doi:10.2337/diacare.23.9.1227

Cited by 350 publications

(295 citation statements)

References 13 publications

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“…Metformin may also inhibit the calcium dependent absorption of the vitamin B 12 and intrinsic factor complex at the terminal ileum. This inhibitory effect could be reversed with calcium supplementation 22 .…”

Section: Clinical Studies Of Vitamin B 12 Deficiency In Indian Populamentioning

confidence: 99%

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Metformin Use and Vitamin B<SUB>12</SUB> Deficiency in Patients with Type-2 Diabetes Mellitus

Singh¹,

Baheti²

2016

MVP J Med Sci

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Metformin is commonly used oral hypoglycaemic agent in the treatment of type-2 Diabetes Mellitus (DM). One of the important side effect of long term metformin therapy is malabsorption of vitamin B 12 which could lead to megaloblastic anemia and peripheral neuropathy. Therefore annual screening of serum vitamin B 12 level or serum methylmalonic acid (MMA)/serum homocysteine level should be done in cases taking metformin for more than four to five years with average dose of >1g per day, even in the absence of haematological or neurological abnormalities. However, as the incidence of type-2 DM is increasing, cost of annual measurement of vitamin B 12 level also increases. Considering cost factor for annual screening, vitamin B 12 supplementation appears to be more cost effective approach rather than annual screening for routine prophylaxis. Routine vitamin preparations available in the market may contain less amount of B 12 and hence are not of much therapeutic use in treatment of B 12 deficiency due to Metformin. Hence there is a need to look for higher doses of approximately 500-2000μg/day.

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Section: Clinical Studies Of Vitamin B 12 Deficiency In Indian Populamentioning

confidence: 99%

“…However, malabsorption of vitamin B 12 may not be easily diagnosed without close attention. Various studies have reported that an average of 10-30 % of patients taking metformin for longer duration and at higher dosage have shown vitamin B 12 deficiency [6][7][8][9] .…”

Section: Introductionmentioning

confidence: 99%

Metformin Use and Vitamin B<SUB>12</SUB> Deficiency in Patients with Type-2 Diabetes Mellitus

Singh¹,

Baheti²

2016

MVP J Med Sci

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“…It can also prevent vitamin B 12 deficiencies, which are common among T2DM patients treated with metformin [24]. It has also been shown that vitamin B 12 status can be improved by calcium supplementation [25], which was reported by only about 10% of the patients treated with metformin; this is unfortunate, given their very poor dietary calcium intake.…”

Section: Discussionmentioning

confidence: 83%

Dietary Supplementation During Diabetes Therapy and the Potential Risk of Interactions

Zabłocka‐Słowińska¹,

Dzielska²,

Gryszkin³

et al. 2014

Adv Clin Exp Med

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Background. The classification of dietary supplements as foodstuffs promotes widespread access to them and increases the possibility of patients using them without being monitored. Unreasonable or excessive consumption of these preparations poses risks to type-2 diabetes mellitus (T2DM) patients (among others) because it may induce disturbances in glycemic control. The aim of this study was to assess the frequency of dietary supplementation among patients using anti-diabetic drugs and such patients' nutrient intake in order to evaluate the potential risk of interactions. Material and Methods. The study participants were 150 diabetic patients who were asked about the type of pharmacotherapy and dietary supplementation they used. The intake of minerals, vitamins, dietary fiber and long-chain polyunsaturated fatty acids (LC-PUFAs) from the patients' diets were also assessed, using the 24-h dietary recall method. Results. The highest percentage of patients taking individual anti-diabetic drugs used supplements containing magnesium and herbs. They also often took antioxidant vitamins, B-group vitamins and omega-3 fatty acids. In the majority of patients (both those using supplements and those not), the dietary recall showed insufficient intake of potassium, calcium and magnesium, as well as of vitamin E, folic acid, vitamin D and LC-PUFAs. In addition, their diets provided high median amounts of iron, copper, vitamin A and β-carotene. Conclusions. The level of dietary supplementation and the ill-balanced diets reported by the majority of the recruited T2DM patients indicate a high possible risk of interactions with the anti-diabetic drugs. Therefore, patients should always consult their physicians regarding dietary supplementation, and medically trained staff should routinely assess dietary intake to avoid hazardous changes in the activity of drugs (Adv Clin Exp Med 2014, 23, 6, 939-946).

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“…Dans le traitement par la metformine [10,26], le risque carentiel n'apparait que pour une dose moyenne de 2 g.j −1 et après une durée moyenne de traitement de 4 ans [80]. La metformine confère à la membrane des cellules pariétales de l'iléon une charge positive qui inhibe l'endocytose calciumdépendante du complexe vitamine B12-FI ; cette inhibition est réversible après un apport calcique [18].…”

Section: Malabsorption De La Vitamine B12unclassified

Carence en vitamine B12 (1^repartie) : mise au point

Loup-Leuciuc

Loup

Lombardi

et al. 2011

Med Buccale Chir Buccale

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(Reçu le 12 mai 2011, accepté le 24 juin 2011) Mots clés : vitamine B12 / métabolisme / carence / manifestationsRésumé -Classiquement, la carence en vitamine B12 s'accompagne d'une anémie mégaloblastique, de manifestations neuropsychiatriques et d'une glossite de Hunter. En réalité, les manifestations sont protéiformes et chacune d'elles peut rester longtemps isolée. Les manifestations stomatologiques, souvent discrètes, peuvent précéder de plusieurs années les autres manifestations. Elles constituent parfois un signe d'appel pour le dépistage précoce de cette carence. Depuis une bonne dizaine d'années, la conception de la physiopathologie de la carence en vitamine B12 a beaucoup évolué : on a identifié le syndrome de non-dissociation de la vitamine B12 des protéines porteuses qui constitue maintenant la principale cause de carence en vitamine B12 et il a été démontré qu'on peut effectuer un traitement de la carence per os. Key words: vitamin B12 / metabolism / deficiency / manifestationsAbstract -Vitamin B12 deficency. Part 1: update and littérature review. Vitamin B12 deficiency is classically accompanied by a megaloblastic anemia, neuropsychiatric disorders and an Hunter glossitis. Clinical manifestations are indeed polymorphic and each may remain the only one for a long period of time. Stomatological manifestations, often mild, may precede the others of many years. They sometimes are the first sign to early diagnose this deficiency. Since the last ten years, the physiopathology of vitamin B12 deficiency has considerably changed. In fact, nowadays, the main cause is the syndrome of food cobalamin malabsorption. It has also been demonstrated that the deficiency may now treated by an oral cobalamin therapy.La vitamine B12 est une vitamine hydrosoluble qui a une structure chimique proche de celle de l'hème avec un atome central constitué par du cobalt, d'où le nom de cobalamine (Fig. 1).Elle existe sous plusieurs formes regroupées dans la famille des cobalamines : cyanocobalamine, hydroxocobalamine, mé-thylcobalamine et adénosylcobalamine. La cyanocobalamine et l'hydroxocobalamine sont les seules formes stables. On peut considérer que les recherches sur la vitamine B12 ont commencé au XIX e siècle avec la description d'une anémie mortelle, l'anémie pernicieuse, par Thomas Addison et Michael Anton Biermer. Vers 1920, George Whipple, George Minot et William Murphy, tous les trois Prix Nobel de médecine en 1934, ont démontré que des extraits de foie sous forme de compléments alimentaires étaient susceptibles de corriger certaines anémies. On en a conclu que les extraits de foie contenaient le facteur extrinsèque, en réalité de la vitamine

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Increased intake of calcium reverses vitamin B12 malabsorption induced by metformin.

Cited by 350 publications

References 13 publications

Metformin Use and Vitamin B<SUB>12</SUB> Deficiency in Patients with Type-2 Diabetes Mellitus

Metformin Use and Vitamin B<SUB>12</SUB> Deficiency in Patients with Type-2 Diabetes Mellitus

Dietary Supplementation During Diabetes Therapy and the Potential Risk of Interactions

Carence en vitamine B12 (1^repartie) : mise au point

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Increased intake of calcium reverses vitamin B12 malabsorption induced by metformin.

Cited by 350 publications

References 13 publications

Metformin Use and Vitamin B<SUB>12</SUB> Deficiency in Patients with Type-2 Diabetes Mellitus

Metformin Use and Vitamin B<SUB>12</SUB> Deficiency in Patients with Type-2 Diabetes Mellitus

Dietary Supplementation During Diabetes Therapy and the Potential Risk of Interactions

Carence en vitamine B12 (1repartie) : mise au point

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Carence en vitamine B12 (1^repartie) : mise au point