Vitamina B12 en pacientes diabéticos tipo 2 en tratamiento con metformina

Romero, José María Calvo; Lozano, José

doi:10.1016/j.endonu.2012.06.005

Cited by 23 publications

(14 citation statements)

References 21 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…In different studies, Vitamin B12 deficiency was found in 5.8%, 8.6%, 6.3%, of patients with type 2 diabetes mellitus on metformin. [123] The higher prevalence in our study (35.5%) is not surprising considering that the prevalence of Vitamin B12 in the apparently healthy populations in India have been reported to be as high as 33.3%–67%. [67] A predominantly vegetarian diet could be one of the causes of higher prevalence of Vitamin B12 deficiency in India.…”

Section: Discussionmentioning

confidence: 47%

“…[123456] Without adjusting for duration of diabetes, there was neither a significant difference in serum Vitamin B12 levels nor in the prevalence of Vitamin B12 deficiency. However, the prevalence of Vitamin B12 deficiency in patients on metformin in our study is higher than that reported in Western literature.…”

Section: Discussionmentioning

confidence: 99%

“…Several studies have reported association of Vitamin B12 deficiency in type 2 diabetes patients treated with metformin. [123456] The reported Vitamin B12 deficiency in the general population of India varies from 12% to 67%. [78] The impact of metformin use on an already Vitamin B12 deficient population is an interesting question.…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Serum vitamin B12 levels in type 2 diabetes patients on metformin compared to those never on metformin: A cross-sectional study

Raizada

Jyotsna

Sreenivas

et al. 2017

Indian J Endocr Metab

View full text Add to dashboard Cite

Context:There are limited data about the effect of metformin use on serum Vitamin B12 levels in type 2 diabetes patients from India.Aims:We studied serum Vitamin B12 levels in patients with type 2 diabetes mellitus who were receiving metformin and compared them to those never treated with metformin.Subjects and Methods:A total of 183 patients (“metformin” group 121, “no metformin” group 63) of type 2 diabetes from the endocrinology clinic of a tertiary care center in North India were studied. Serum Vitamin B12 levels were measured in all patients. Diabetic neuropathy symptom score (DNS) and diabetic neuropathy examination score (DNE) were used to assess peripheral neuropathy while hemoglobin and mean corpuscular volume (MCV) were used to assess anemia.Results:The serum Vitamin B12 levels were 267.7 ± 194.4 pmol/l in metformin group and 275.1 ± 197.2 pmol/l in the no metformin group (P = 0.78). When adjusted for duration of diabetes, metformin use was associated with a 87.7 ± 37.7 pmol/l (95% confidence interval [CI], −162.1–−3.3, P = 0.02) lower serum Vitamin B12 levels. No significant increase in the prevalence of neuropathy (DNS and DNE scores), anemia, or MCV was found in the Vitamin B12 deficient patients (levels <150 pmol/l) as compared to patients with normal Vitamin B12. However, serum Vitamin B12 levels for the entire cohort were higher by 12.2 ± 3.0 pmol/l (95% CI 6.4–18.0, P < 0.001) for every 1 year increase in the duration of diabetes.Conclusions:Metformin use was associated with a lower serum Vitamin B12 levels when adjusted for duration of diabetes. Increasing duration of diabetes was associated with higher serum Vitamin B12 levels.

show abstract

Section: Discussionmentioning

confidence: 47%

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Serum vitamin B12 levels in type 2 diabetes patients on metformin compared to those never on metformin: A cross-sectional study

Raizada

Jyotsna

Sreenivas

et al. 2017

Indian J Endocr Metab

View full text Add to dashboard Cite

show abstract

“…An additional nine studies were excluded from review due to an unknown treatment protocol or the lack of clear comparison for VB12 deficiency. From the remaining 29 publications, 22 studies were finalized for quantitative meta-analysis of serum VB12 levels [6,[13][14][15][16][17][18][19][20][21][22][23][24][25][26][27][28][29][30][31][32] and 18 studies were selected for the meta-analysis of the incidence of VB12 deficiency [5,6,13,16,19,21,22,27,[30][31][32][33][34][35][36][37][38][39] (Figs. 3, 4).…”

Section: Study Selectionmentioning

confidence: 99%

The role of metformin on vitamin B12 deficiency: a meta-analysis review

et al. 2014

View full text Add to dashboard Cite

Metformin is the only biguanide oral hypoglycemic drug, that is used to treat patients with type-2 diabetes mellitus. There are some reports of metformin being associated with decreased serum levels of vitamin B12 (VB12). The objective of this study is to systematically analyze the impact of metformin on the frequency of VB12 deficiency and serum levels of VB12. A search of various databases provided 18 retrospective cohort studies and 11 randomized controlled trials. Pooled estimates of odds ratio with 95% confidence interval using random effect model were conducted. Studies were examined for heterogeneity, publication bias and sensitivity analysis. Separate analysis of randomized control trials (RCTs) including both low-risk and high-risk bias was also conducted. 29 studies were selected with a total of 8,089 patients. 19 studies were rated intermediate or high quality. Primary outcome suggested increased incidence of VB12 deficiency in metformin group (OR = 2.45, 95% CI 1.74-3.44, P < 0.0001.) Heterogeneity was relatively high (I(2) = 53%), with minor publication bias. Secondary outcome suggested 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 revealed similar trends. We conclude that metformin treatment is significantly associated with an increase in incidence of VB12 deficiency and reduced serum VB12 levels.

show abstract

“…Asimismo, sería importante conocer si los participantes del estudio mostraron sintomatología debido a los niveles bajos de vitamina B12 y al mismo tiempo la dosis máxima de metformina que tuvieron, ya que solo se menciona el tiempo mínimo de ingesta de este medicamento (5).…”

unclassified

Importancia De Descartar Factor De Riesgo Por Edad en La Deficiencia De Vitamina B12 Inducida Por Uso De Metformina

Cruz

Maeshiro

2016

Nutr Hosp

View full text Add to dashboard Cite

Recientemente leímos con mucho interés su artículo "Déficit de vitamina B12 asociado con altas dosis de metformina en adultos mayores diabéticos". La ficha técnica de la metformina elaborada por la Agencia Española de Medicamentos y Productos Sanitarios menciona entre las reacciones adversas que se han observado una disminución de la absorción de vitamina B12 y sus niveles séricos en pacientes que han sido tratados de forma crónica con metformina. Sin embargo, esto no parece tener significancia clínica (< 0,01%) (1).Por otro lado, en otro estudio se estima que entre el 10% y el 30% de los pacientes que toman metformina presenta un déficit de vitamina B12 que aparecería, a pesar de una ingesta adecuada de vitamina en la dieta, a los 10-15 años (2). Sin embargo, dentro de las personas que evaluaron en su estudio se tuvieron en cuenta a personas que tomaron como mínimo dos años este medicamento. Esto podría indicar que la deficiencia de vitamina B12 no se debería principalmente al uso de este medicamento ya que los pacientes no lo han tomado por largo periodo.Esto podría estar vinculado a otro factor como la edad, tal como ustedes mencionan en su estudio. La deficiencia de vitamina B12 se observa con mayor frecuencia en adultos mayores. En un estudio que se realizó con 3.511 personas se encontró que uno de cada veinte personas mayores de 65 años y uno de cada diez mayores de 75 años presentaban niveles bajos de vitamina B12 (3). Por ello, se puede evidenciar que los adultos mayores son un grupo de riesgo para padecer este tipo de deficiencia debido a que esta población suele presentar baja acidez gástrica, menos aporte de proteínas animales en la dieta y gastrectomía, entre otros factores (4). Esta condición podría influir en el resultado de su estudio y la deficiencia encontrada en su población puede estar más ligada a la edad que al uso del medicamento.Asimismo, sería importante conocer si los participantes del estudio mostraron sintomatología debido a los niveles bajos de vitamina B12 y al mismo tiempo la dosis máxima de metformina que tuvieron, ya que solo se menciona el tiempo mínimo de ingesta de este medicamento (5).Las respuestas a estas preguntas seguramente contribuirán a fortalecer los resultados que menciona el estudio. Gisela Cruz y Karina Maeshiro Nutrición y dietética. Universidad Peruana de CienciasAplicadas. Lima. Perú (giseladas_41@hotmail.com

show abstract

Vitamina B12 en pacientes diabéticos tipo 2 en tratamiento con metformina

Cited by 23 publications

References 21 publications

Serum vitamin B12 levels in type 2 diabetes patients on metformin compared to those never on metformin: A cross-sectional study

Serum vitamin B12 levels in type 2 diabetes patients on metformin compared to those never on metformin: A cross-sectional study

The role of metformin on vitamin B12 deficiency: a meta-analysis review

Importancia De Descartar Factor De Riesgo Por Edad en La Deficiencia De Vitamina B12 Inducida Por Uso De Metformina

Contact Info

Product

Resources

About