The efficacy of vitamin B12 supplementation for treating vitamin B12 deficiency and peripheral neuropathy in metformin-treated type 2 diabetes mellitus patients: A systematic review

Pratama, Samuel; Lauren, Brigitta Cindy; Wisnu, Wismandari

doi:10.1016/j.dsx.2022.102634

Cited by 23 publications

(21 citation statements)

References 38 publications

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“…The current study found higher hypertriglyceridemia with Vitamin B12 deficiency. Contrary to our study, a study from Poland with 62 patients didn't find any association between B vitamins and hyperlipidemia (16). The current concept that drives us to investigate this association is malonyl-CoA accumulation due to vitamin B12 deficiency, which could result in increased lipogenesis and inhibit fatty acid oxidation (17).…”

Section: Resultscontrasting

confidence: 86%

Vitamin B12 deficiency in turkish patients with Type 2 Diabetes Mellitus

2023

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Objective: Type 2 diabetes (T2DM) disease and related changes in blood parameters bring essential health risks. This study was carried out to determine the frequency of vitamin B12 deficiency in T2DM patients, the effect of B12 deficiency on blood glucose, HbA1c control and lipid parameters, and the B12 level in diabetes patients using metformin. Material and Methods: 287 patients with T2DM who were followed up in the Endocrinology department of Istanbul Training and Research Hospital were evaluated. After the patients called for control had fasted for 8 hours, blood tests were performed, and biochemical parameters were determined with standard laboratory techniques. Vitamin B12 <180 mg/dl was accepted as a deficiency, and patients were divided into groups regarding vitamin B12 deficiency. The chemiluminescence method was used to determine serum Vitamin B12 levels. Data were analyzed using SPSS version 22.0 (IBM Corporation, Armonk, NY, USA). Results: A total of 287 T2DM patients were included in the study. B12 deficiency is present in 29.8% of T2DM patients. Vitamin B12 values were found to be lower in patients with T2DM using metformin (280.2 pg /ml ±151.06 pg/ml, p<0.05); however, lower vitamin B12 values did not have a significant effect on blood sugar control (p=0,3), and hypovitaminosis Vitamin B12 was associated with elevated hypertriglyceridemia (p=0,03). Conclusion: According to the current study, serum vitamin B12 level was not associated with blood glucose and HbA1c; a relationship was found between vitamin B12 deficiency and higher hypertriglyceridemia. A significant proportion of T2DM patients using metformin had lower levels of vitamin B12 compared to T2DM patients not using metformin. Vitamin B12 levels should be monitored regularly in the follow-up of patients with T2DM using metformin.

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Section: Resultscontrasting

confidence: 86%

Vitamin B12 deficiency in turkish patients with Type 2 Diabetes Mellitus

2023

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“…Vitamin B12 (VitB12) is an essential water-soluble micronutrient [20] . It is necessary for the body's growth and development because it participates in a number of metabolic and synthetic processes [21,22] , where it works as a coenzyme for certain enzymes and is involved in hematopoietic and neurological functions, as well as DNA synthesis and regulation [20 _ 22] .…”

Section: Discussionmentioning

confidence: 99%

Effect of metformin on vitamin B12 and homocysteine levels among Sudanese with type 2 diabetes mellitus

Al-Ghaili,

tayrab

2024

Preprint

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Background: Metformin is the first-line treatment for type 2 diabetes mellitus (T2DM), and hyperglycemia. When taken in high doses or for an extended period, metformin may decrease vitamin B12 (VitB12) level and may increase homocysteine (Hcy) level. There has been no research conducted in Sudan to determine whether metformin has an impact on VitB12 and Hcy levels in individuals withT2DM. The aim of this research is to investigate the effect of metformin on VitB12 and Hcy levels among Sudanese with T2DM. Methods: This cross-sectional study included 98 Sudanese with T2DM who had been taking metformin for at least a year. Data analysis was carried out using SPSS V-26. Results: This study found that 1 patient (1%) had a VitB12 deficiency (< 180 pg/mL), 52 (53.1%) subjects had a normal VitB12 level (180 - 900 pg/mL), and 45 (45.9%) subjects had VitB12 ≥ 900 pg/mL. One patient (2.9%) had an Hcy deficiency (< 3µmol/l) and 34 (97.1%) subjects had a normal Hcy level (3–15 µmol/L). The study showed a, significant negative correlation between VitB12 and vitamin supplements (P = 0.003) and metformin combined with insulin (P = 0.000). Although that belongs to the subgroup that took vitamin supplements, there was a significant positive correlation between VitB12 and metformin alone (P = 0.006) and a significant negative association with metformin combined with insulin (P = 0.000). In the subgroup that did not take vitamin supplements, there was a significant positive correlation between VitB12 and FBS (P = 0.001). There was an insignificant correlation between VitB12 and the metformin dose and use duration. The correlation between VitB12 and Hcy levels was insignificant in the entire group and in both subgroups. The correlation between Hcy levels and metformin use duration was significantly negative (P = 0.015), but the correlation between Hcy levels and metformin dose was insignificant. Conclusions: In Sudanese with T2DM and under metformin treatment, serum VitB12 level was positively and significantly correlated with DM duration and (FBS), was significantly and negatively correlated with vitamin supplements. On the conversely, serum homocysteine (Hcy) levels significantly decreased with metformin use duration.

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“…However, vitamin B12 deficiency should be suspected in diabetic patients on longterm metformin therapy with neuropathy or anemia. Pratama et al (2022) supported the implementation of vitamin B12 supplementation for metformin-treated T2D. However, a recent meta-analysis has shown that, whilst long-term metformin use is associated with vitamin B12 deficiency, it is not related to an increased prevalence of DPN (Yang et al 2019)…”

Section: -Treatment Based On Pathogenetic Mechanismsmentioning

confidence: 99%

A new look for the management of Painful Peripheral Neuropathy in Diabetes

Elnahaas

2023

Medicine Updates

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The efficacy of vitamin B12 supplementation for treating vitamin B12 deficiency and peripheral neuropathy in metformin-treated type 2 diabetes mellitus patients: A systematic review

Cited by 23 publications

References 38 publications

Vitamin B12 deficiency in turkish patients with Type 2 Diabetes Mellitus

Vitamin B12 deficiency in turkish patients with Type 2 Diabetes Mellitus

Effect of metformin on vitamin B12 and homocysteine levels among Sudanese with type 2 diabetes mellitus

A new look for the management of Painful Peripheral Neuropathy in Diabetes

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