Vitamin B12 deficiency in patients with diabetes at a specialised diabetes clinic, Botswana

Abstract

To estimate the prevalence of Vitamin B12 deficiency among patients with diabetes. Methodology: This cross-sectional study was undertaken on 351 patients with diabetes at a specialised public diabetes clinic in Gaborone between July 2017 and October 2017. Clinical, anthropometry and laboratory data were collected. Vitamin B12 deficiency was defined by levels < 150 pmol/l. Results: The mean (SD) age of the participants was 57 ( 15) years, two-thirds (67.2%) were females, and the majority (92.9%) had Type 2 diabetes. Most (89.5%) participants were on metformin. The prevalence of vitamin B12 deficiency was 6.6%. Compared with participants with normal Vitamin B12 levels, deficient participants were significantly older (64 vs. 56 years, p = 0.014) and had a longer duration of metformin use (7 vs. 4 years, p = 0.024). The use of acid blockers was also associated with vitamin B12 deficiency (p = 0.012). There was no difference in the prevalence of peripheral neuropathy between those with normal and deficient vitamin B12 levels. Conclusion: Vitamin B12 deficiency exists among patients with diabetes in the setting discussed. Regular vitamin B12 assessment may be beneficial, especially among diabetes patients who are old, those taking metformin over a long duration and patients on acid blockers.

Does Metformin in different doses cause vitamin B12 deficiency? A cross-sectional study

“…The results of examining the gender variable of the patients showed that most of the studied patients were female, which is the same as the results of the study by Kwape et al (2021) in Botswana, where most of the studied patients were female (29). While in other studies, unlike the present study, most of the examined patients were male (30,31).…”

Prevalence of Vitamin B12 deficiency in patients with type 2 diabetes mellitus on Metformin therapy at a single centre in Johannesburg, South Africa

“…The prevalence of B12 deficiency amongst people with diabetes across Southern Africa varies, ranging from 6.6% to 28.1%. (20,25) This observation is similar to that observed in high-income countries and could be a function of many factors. The disparity (almost double) in the prevalence of B12 deficiency between our cohort and that of Ahmed et al (28.1%) was an unexpected finding, given that both studies were conducted in tertiary hospitals in the same province of Gauteng.…”

“…(20) The mean age in our study was 61.5 ± 12.1 years of age, similar to both the Botswana and South African studies, where the mean ages were 57 ± 15 and 58.5 ± 10.5 years, respectively. (20,25) In our study, B12-deficient patients were significantly older than those not B12-deficient. We noted the same trend in Ahmed and colleagues' report.…”

“…Similar studies conducted in Pretoria (South Africa) and Botswana did not report comparable findings concerning B12 deficiency prevalence by race. (20,25) This finding is likely attributable to a much smaller representation of the Coloured population in the Pretoria cohort (2.5%) and the absence of the Coloured community in the Botswana study.…”

“…(13,21,22) There are few studies on metformin use and associated B12 deficiency conducted in Africa. (23)(24)(25)(26) South Africa is one of the most ethnically diverse countries in Africa. Regarding race, South Africans are classified into four groups: Blacks, Whites, Coloureds, and Indians, who constitute 81.4%, 7.3%, 8.2% and 2.7% of the population, respectively.…”