information submitted for this request. Furthermore, because of the paucity of data on Saudi patients, this study aimed to find the prevalence of vitamin B12 deficiency in metformin-treated T2DM patients in selected Ministry of Health (MoH) hospitals in Riyadh, Saudi Arabia, and determine the knowledge and perception of physicians on vitamin B12 screening, to be able to make a recommendation for screening, as suggested by ADA and the European Association for the study of diabetes.[2627]. Diabetes mellitus (DM) is a chronic metabolic disease with increasing prevalence worldwide. Yes, vitamin B complex is very healthy for people with diabetes as it only interferes with medications for diabetes. Other disorders that interfere with the absorption and metabolism of vitamin B12 can also result in cobalamin deficiency, with the development of a macrocytic anemia and neurologic complications. The https:// ensures that you are connecting to the 2012;35:e84. eCollection 2019. A total of 100 physicians responded and consented to participate in the study. Journal of Korean Medical Science 2014. People who take metformin for type 2 diabetes have lower levels of vitamin B12. Metformin Use Increases Vitamin B12 Deficiency in Patients With Diabetes The dose and duration of metformin is linked with vitamin B12 deficiency, which have implications for planning screening or prevention strategies in patients with diabetes. Regulate your bodys diabetes level by regulating the amount of vitamin B12. Vitamin B1: Aids the breakdown of carbohydrates.Vitamin B2 Aids the metabolism of carbohydrates, protein, and fat.Vitamin B3 Aids the metabolism of carbohydrates, fat, and alcohol.Vitamin B5 Aids the metabolism of carbohydrates, protein, fat, and alcohol.Vitamin B6 Aids the metabolism of carbohydrates and protein.More items 2009;32:193203, 28. Make sure to take a regular intake of this vitamin for diabetes and treatment of other diseases. Older adults and people with digestive tract conditions that affect absorption of nutrients also are susceptible to vitamin B-12 deficiency. Therefore, we focused on the other objectives of the study. There was no difference in the prevalence of peripheral neuropathy between those with normal and deficient vitamin B12 levels. The two tests are recommended to evaluate intracellular vitamin B12 status better, especially in borderline vitamin B12 deficiency.Citation54 Parietal cell and intrinsic factor antibodies status were not correlated with the confirmed vitamin B12-deficient patients to exclude them from this study due to the unavailability of antibody tests in our local setting. You can control blood glucose level in your body by increasing intake of vitamin B12. Vitamin B12 deficiency symptoms Symptoms due to anaemia These are caused by the Metformin-induced vitamin B12 deficiency presenting as a peripheral neuropathy South Med J. When IF binds with Vitamin B12, a vitamin B12-IF complex forms, this complex plays a vital role in the absorption of vitamin B12 in your body. Diabetic neuropathy was evaluated by patient record, nerve conduction and Michigan test for the diagnosis of diabetic neuropathy. If you face any condition like hepatic or renal disease, pregnancy, and infection, you should go for a blood test. Type 1 diabetics and patients who had a history of pernicious anemia, chronic renal insufficiency, prior bariatric surgery, prior gastrectomy, vitamin B12 supplementation with B12 injections or an oral dose of >500 g/day, prior ileum resection, or Crohn's disease were excluded from the study. 14-16 In addition, previous studies have shown that circulating folate concentrations are significantly lower in patients with T2D compared with healthy individuals. RESULTS Biochemical B 12 deficiency was present in 5.8% of those with diabetes using metformin compared with 2.4% of those not using metformin ( P = 0.0026) and 3.3% of those Also, add a good amount of green leafy vegetables to your diet. These symptoms are pain and numbness in the arms, legs, hands, and feet. Subsequently, every fifth patient in the clinic attendees was selected until the days desired sample size was reached. Chi-square test was used to determine significant difference between two proportions or groups. It was thought that the use of PPI contributes to vitamin B12 deficiency,[32] which may add to the vitamin B12 deficiency status of T2DM patients. 2016;12:35968, 4. While the recommended daily amount of vitamin B-12 for adults is 2.4 micrograms, higher doses have been found to be safe. Please refer to the 'Licensing' tab on the article menu bar for information on the reuse conditions associated with this license type. Methods: We conducted a cross-sectional study at the diabetic clinics of four hospitals in Riyadh, Saudi Arabia. Endocrinol. Well, vitamin B12 does not play a role in the management of blood glucose levels. 2014;10:93102, 16. Vitamin B12 deficiency is highly prevalent, especially in patients with diabetic neuropathy. Mayo Clinic does not endorse companies or products. 2019 May 23;7:2050312119853433. doi: 10.1177/2050312119853433. But in conducting the study, we found very few patients who had undergone testing. Diabetes: Fact sheet [Internet]. Bethesda, MD 20894, Web Policies Thats why it is said that calcium reverses the absorption of vitamin B12 and diabetes. Metformin Treatment: A Potential Cause of Megaloblastic Anemia in Patients with Type 2 Diabetes Mellitus. If a patients mood is low at the same time, this can easily be interpreted as depression. The duration of metformin use is dependent on the patients history and thus subject to recall bias. Moreover, the risk of vitamin B12 deficiency also increases with increased metformin dose and duration of its use. Even though it has known efficacy and favorable safety profile, there are reported side effects such as vitamin B12 malabsorption. Keywords: Cobalamin Diabetes mellitus Metformin Metformin-induced vitamin B12 deficiency can cause or worsen distal symmetrical, autonomic and cardiac neuropathy in the patient with diabetes. Objective: The first possible treatment option is to look at your diet. [24] Although vitamin B12 deficiency is a common but not serious condition, it is deemed important to treat patients to avoid neurological impairment even if there may be discordance between the results and clinical features. The https:// ensures that you are connecting to the 405412. You may be trying to access this site from a secured browser on the server. The data collection was done in the clinic using a data extraction form. 2016 Mar;39(3):305-14. doi: 10.1007/s40618-015-0365-9. Would you like email updates of new search results? In this study an inverse correlation was found between diabetic neuropathy 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. The recommended daily amount of vitamin B-12 for adults is 2.4 micrograms. Filioussi K, Bonovas S, Katsaros T. Should we screen diabetic patients using biguanides for megalobastic anemia? Higher doses of metformin and male sex were factors related to lower levels of vitamin B12. 2021 Nov 26;9(33):10198-10207. doi: 10.12998/wjcc.v9.i33.10198. When it comes to increasing the level of vitamins for diabetes, people usually take supplements. Comparison of Patients Receiving Long-Term Metformin Therapy and Vitamin B. To make your body function smoothly, you should also take medications for the effective absorption of B12. The mean age of the patients was 53.72 11.31 years (ranged from 25 to 84 years old). 2013;36:S1166, 27. [56] Reports have shown that vitamin B12 deficiency occurs in 5.830% of diabetic patients on long-term treatment with metformin. 2015 Dec;41(6):550-5. doi: 10.1016/j.encep.2015.07.004. Office of Dietary Supplements. Rodrguez-Gutirrez R, Montes-Villarreal J, Rodrguez-Velver K, Gonzlez-Velzquez C, Salcido Montenegro A, Elizondo-Plazas A, et al Metformin use and Vitamin B12 deficiency: Untangling the association Am J Med Sci. WebVitamin B12 deficiency is highly prevalent, especially in patients with diabetic neuropathy. Accessed Jan. 9, 2021. Vitamin B12 is an essential micronutrient required for optimal hemopoetic, neuro-cognitive and cardiovascular function. Cyanocobalamin. Among those who took metformin for at least 1 year, 9 had vitamin B12 level < 240 pg/ml (56.2%); 23 diabetic patients did not get metformin and only 4 had vitamin B12 level < 240 pg/ml (17.4%) (P = 0.014). The prevalence of vitamin B12 deficiency increases with age due to either inadequate dietary intake or impaired vitamin B12 absorption.Citation37 Ageing is associated with decreases in taste acuity and smell, deteriorating dental health and a reduction of physical activity, which may all affect nutrient intake.Citation38 Insufficient nutritional intake of vitamin B12 accounts for about 2% of the vitamin B12 deficiency in the elderly, especially those living in institutions.Citation39 Vitamin B12 malabsorption is the most frequent cause of vitamin B12 deficiency in the elderly, accounting for about 40% to 70% of cases.Citation39,Citation40 It is caused by atrophic gastritis that occurs in 20% to 50% of the elderly population. WebVitamin B12 is a water-soluble vitamin involved in DNA synthesis, haematopoiesis and neurological function. Vitamin B12 deficiency in diabetic people is quite common. [2] In 2015, diabetes was the leading cause of 1.6 million deaths and World Health Orgnization projects that diabetes will be the seventh most important cause of death by 2030. Lastly, genetic and environmental differences could be the other factors that explain the variation in the prevalence of vitamin B12 deficiency in different settings.Citation26 Several single-nucleotide polymorphisms (SNPs) in multiple genes interact with environmental factors to cause vitamin B12 deficiency.Citation27, Consistent with previous studies, metformin use was associated with vitamin B12 deficiency in our patients.Citation19 In the present study, vitamin B12 deficient patients had a longer duration of metformin use, as reported in other studies.Citation19,Citation28 Levels of serum B12 are inversely associated with the dose and duration of metformin use.Citation5,Citation10,Citation2831 Reports have shown a decrease in vitamin B12 levels as early as four months after initiation of metformin.Citation10,Citation31 The exact mechanism of this association is unknown but is ascribed to the binding of the hydrophobic tail of biguanide to the hydrocarbon core of membranes. 14-16 In addition, previous studies have shown that circulating folate concentrations are significantly lower in patients with T2D compared with healthy individuals. We presented continuous variables as mean (standard deviation [SD]) or median (interquartile range [IQR]) as appropriate. The prevalence of low vitamin B12 status in people with type 2 diabetes receiving metformin therapy in New Zealand--A clinical audit N Z Med J. https://www.micromedexsolutions.com. Gastritis is due to either Helicobacter pylori (H. pylori) infection or autoimmune mechanisms.Citation41,Citation42 H. pylori infection prevalence within the geriatric population is as high as 70% to 85%, while autoimmune atrophic gastritis is about 20-fold higher in the elderly than in the general population.Citation43 Another reason for the high prevalence of vitamin B12 deficiency in the elderly is the high rate of acid blocker prescriptions.Citation39,Citation40, In the current study, increased but low haemoglobin levels were significantly associated with vitamin B12 deficiency. There were 205 patients 56.5% who had a daily dose of 750 mg of metformin. Top Warning Signs of B12 DeficiencyTiredness. If you often feel exhausted, regardless of how much sleep youve gotten or how much energy youve exerted, it could be a sign that your body is lacking Mood swings. Do you find yourself experiencing a variety of emotions throughout any given day? It may result in depression. Digestive issues. Inflammation of the mouth and tongue. Insomnia. More items 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. 2013;71:38690, 12. Albai O, Timar B, Paun DL, Sima A, Roman D, Timar R. Diabetes Metab Syndr Obes. Some people suffer from serious symptoms such as shortness of breath, dizziness, fatigue, and a fast heartbeat. [25] There have been no studies that explored the knowledge and perceptions of physicians on vitamin B12 screening. A hospital-based screening study using a panel of serum biomarkers, Seroprevalence of Helicobacter pylori and length of stay in a nursing home, Independent effect of vitamin B12 deficiency on hematological status in older Chinese vegetarian women, Prevalence and possible factors associated with anaemia, and vitamin B 12 and folate deficiencies in women of reproductive age in Pakistan: analysis of national-level secondary survey data, Evaluation of current criteria used to measure vitamin B12 levels, Cobalamin status and its relation with depression, cognition and neuropathy in patients with type 2 diabetes mellitus using metformin, Serum vitamin B12 levels in type 2 diabetes patients on metformin compared to those never on metformin: A cross-sectional study, Investigation of the vitamin B12 deficiency with peripheral neuropathy in patients with type 2 diabetes mellitus treated using metformin, Association of metformin, elevated homocysteine, and methylmalonic acid levels and clinically worsened diabetic peripheral neuropathy, The role of metformin on vitamin B12 deficiency: a meta-analysis review, Vitamin B12 deficiency and the lack of its consequences in type 2 diabetes patients using metformin, Neurologic aspects of cobalamin deficiency, Biomarkers of vitamin B12 status in NHANES: a roundtable summary, Reliability and validity of the modified Toronto clinical neuropathy score in diabetic sensorimotor polyneuropathy, Journal of Endocrinology, Metabolism and Diabetes of South Africa. 2015 Aug;31(4):184-189. doi: 10.1177/8755122515576207. 2017Last accessed on 2019 Jan 28 Available from: 3. The PubMed wordmark and PubMed logo are registered trademarks of the U.S. Department of Health and Human Services (HHS). There were 39 diabetic patients, 16 took metformin for at least 1 year. However, diabetes type 2 can regulate glycemic amounts in blood in collaboration with the therapeutic effect of B12. There were 39 diabetic patients, 16 took metformin for at least 1 year. We chose the four hospitals according to availability of Vitamin B12 test. FOIA Elsaier A, Elamami A, Zaid A. Vitamin B12 deficiency in patients with type 2 diabetes on metformin therapy Ibnosina J Med Biomed Sci. Lam DW, LeRoith D. The worldwide diabetes epidemic Curr Opin Endocrinol Diabetes Obes. Well, you can fulfill vitamin B12 intake through energy bars and breakfasts having fortified B12. (10.3346/jkms.2014.29.7.965) 69 Vitamin B12 deficiency could be a modifiable risk factor for neuropathy in those patients. Clin Diabetes. 2019 Aug;69(Suppl 3)(8):S40-S44. A single copy of these materials may be reprinted for noncommercial personal use only. National Library of Medicine There were only 16 patients (4.4%) who had available serum vitamin B12 levels. Routine vitamin B12 screening may prevent irreversible nerve damage in type-2 diabetes Patients with type-2 diabetes, taking metformin, should have their vitamin B12 levels assessed more regularly to avoid irreversible nerve damage, according to a new study presented at the Society for Endocrinology annual conference in Glasgow. Vitamin B12 status and peripheral neuropathy in patients with type 2 diabetes mellitus. McCreight LJ, Bailey CJ, Pearson ER. The first possible treatment option is to look at your diet. McCreight LJ, Bailey CJ, Pearson ER. The clinic has been operational since 2011 as a referral centre for health facilities in Gaborone and nearby towns. Folic acid with or without vitamin B12 for cognition and dementia. FOIA Clinicodemographic profile of 363 T2DM patients on metformin use, Frequencies of daily doses of metformin, types of OHA used, PPI use, vitamin B12 supplement use, and daily doses of vitamin B12, Gender differences in the use of PPI, vitamin B12 supplements and duration of T2DM, duration and dose of metformin use, and vitamin B12 levels, The use of PPI, vitamin B12 supplements and duration of T2DM, duration and dose of metformin use, and vitamin B12 levels according to age groups, Demographic profile of 100 physicians who participated in the study on knowledge and perception about vitamin B12 screening, Knowledge of physicians about the current ADA recommendations on, Responses of 100 physicians on when do they order vitamin B12, 1. Association of vitamin B12 deficiency and metformin use in patients with type 2 diabetes J Korean Med Sci. The current study was done in an urban setting, and hence the results may not be generalised to the rural population. An official website of the United States government. There are a few different options as far as how you can treat your vitamin b12 deficiency if you are diabetic. Vitamin B 12 deficiency associated with metformin is relatively common in our area. Biochemical and clinical vitamin B12 deficiency has been demonstrated to be highly prevalent among patients with type 1 and type 2 diabetes mellitus. While in anemia, the number of healthy red blood cells to carry out oxygen depletes. There were 41 (41.0%) males and 59 (59.0%) females. Long-term metformin therapy and vitamin B12 deficiency: An association to bear in mind. Using metformin therapy for a long time is a cost-effective and practical treatment of blood glucose level maintenance. Metab., 101 (2016), pp. Your body absorbs only as much as it needs, and any excess passes through your urine. Recommendations for Practical Use of Metformin, a Central Pharmacological Therapy in Type 2 Diabetes. The prevalence of vitamin B12 deficiency was 6.6%. Vitamin B 12 deficiency was defined as vitamin B 12 300 pg/mL without folate deficiency (folate > 4 ng/mL). Results About 29.66% of diabetic patients had confirmed the B12 insufficiency through laboratory tests. The first thing you should keep in mind while treating vitamin B12 deficiency is to act upon a doctors prescription. Table 1 shows the clinicodemographic profile of all patients. The majority were females (67.2%) and those with type 2 diabetes (92.9%). You dont have to take Vitamins supplements if you are facing a minor B12 deficiency. Weight Bookshelf Mayo Clinic is a nonprofit organization and proceeds from Web advertising help support our mission. An estimated sample size of 354 patients was calculated. Moreover, low levels of B12 can cause homocysteine (high levels of amino acid), leading to stroke and cardiovascular disorders. [Neuropsychiatric manifestations ushering pernicious anemia]. You can obtain it through meat, poultry, fish, and dairy products. There were 210 patients (57.9%) who were on vitamin B12 supplementation, of which 111 (30.6%) had a daily dose of 200 mcg. In this study an inverse correlation was found between diabetic neuropathy and the plasma level of vitamin B12. Please try again soon. Any use of this site constitutes your agreement to the Terms and Conditions and Privacy Policy linked below. In those with diabetic neuropathy, altered (low and borderline) vitamin B12 level was 64% (95% CI: 47-78%) compared to 17% (95% CI: 10-26%) in patients without diabetic neuropathy (coefficient: -110.8; CI 95%: -165.8, -59.7). Diabetes patients are often exposed to metformin, as it is an oral medication for hyperglycemia. People with diabetes type 1 are usually at higher risk of getting autoimmune disorders like thyroid problems and coeliac disease. HHS Vulnerability Disclosure, Help Of the 16 patients who had vitamin B12 levels, two (12.5%) had vitamin B12 level below 200 pg/mL. The average B12 level in the blood was 223pg/ml. J. Clin. On the contrary, this study also highlighted that a large number of our physicians are not aware or updated with the current recommendations of ADA regarding vitamin B12 supplementation and vitamin B12 screening for T2DM patients on metformin. Such vitamins are vitamin B1, vitamin B6, biotin, thiamin, and pyridoxine. https://www.uptodate.com/contents/search. On average, diabetic patients should take 300 mcg of biotin, 150 mcg of B12, 1.5 mg of B1, 75 mg of B6, 25 mg of B2, and 2.5 mg of folic acid. 2022 Aug;24(8):1423-1428. doi: 10.1111/dom.14734. Those taking a higher metformin dose had lower levels of vitamin B12 (coefficient: -0.061; CI 95%: -0.09, -0.024). Mayo Clinic does not endorse any of the third party products and services advertised. Severe deficiency (e.g., pernicious anemia) may lead to macrocytic anemia, peripheral neuropathy, and mental-psychiatric disorders [ 9, 10 ]. In most cases, this depletion takes place 3 to 4 months after starting this therapy. Careers. WHO Media Centre. Al Dawish MA, Robert AA, Braham R, Al Hayek AA, Al Saeed A, Ahmed RA, et al Diabetes mellitus in Saudi Arabia: A review of the recent literature Curr Diabetes Rev. Under normal routine, stomach cells create this protein. Endocrinol. to maintaining your privacy and will not share your personal information without
However, It has been suggested that healthy people can have low levels of vitamin B12, and much more vitamin B12 deficiency commonly occurs in around 6% of elderly patients aged 60 years with prevalence increasing with age. In a case-control study among Medicaid patients in the USA, vitamin B12 deficiency was found in 18% of patients using acid blockers compared with 11% in the control group.Citation32 Other previous studies have, however, found no significant association between long-term proton pump inhibitor use and vitamin B12 status.Citation8,Citation33 The connection between vitamin B12 deficiency and proton pump inhibitors or H2 blockers (acid blockers) is primarily due to decreased gastric acidity, contributing to vitamin B12 malabsorption.Citation34 Both the acid blockers and proton pump inhibitors cause a reduction in secretion and discharge of acid discharges by the parietal cells, which are essential for the breakdown of vitamin B12 from nutritional sources.Citation10,Citation34,Citation35 In the absence of gastric acid, vitamin B12 would not be cleaved from dietary protein and would not bind to R-proteins. other information we have about you. The only way to recover from your condition of hyperhomocysteinemia is by taking a regular dose of vitamin B12, vitamin B6, and folic acid. [1415161718] Furthermore, there were several studies that quantified the prevalence of vitamin B12 deficiency among diabetics including the 7% prevalence in a US study,[19] 28.1% prevalence in a South African study,[20] 22.5% in Brazil,[21] 18.7% in New Zealand,[22] 9.7% in the Netherlands,[7] and 9.7% in Libya. The deficiency was significantly common with increased age, long duration of metformin use, and acid blockers. -Chronic treatment should be done with an oral preparation in patients with normal intestinal absorption. In both diabetes type 1 and type 2, diabetic patients experience its deficiency. Lets read how type 1 and 2 diabetes affect the level of Vitamin B12 in your body. Table 2: Factors associated with Vitamin B12 deficiency among patients with diabetes at Princess Marina Hospital diabetes clinic, between July 2017 and October 2017. Research on the use of vitamin B-12 for specific activities and conditions shows: Most people get enough vitamin B-12 from a balanced diet. Alshammari, Amal N.1,; Iqbal, Rafay1; Baksh, Iqra Peer2, 1Department of Family and Community Medicine, Joint Program, Riyadh, Saudi Arabia, 2Department of Dermatology, General Practitioner, Riyadh, Saudi Arabia, Address for correspondence: Dr. Amal N. Alshammari, Department of Family and Community Medicine, Joint Program, Resident R 3, Riyadh, Saudi Arabia. -, Aroda VR, Edelstein SL, Goldberg RB, Knowler WC, Marcovina SM, Orchard TJ, Bray GA, Schade DS, Temprosa MG, White NH, et al. It depicts that vitamin B12 absorption is a calcium-dependent process. Careers. Am J Clin Nutr. This review article offers a current perspective on the physiological roles of vitamin B12, proposed pathophysiological mechanisms of vitamin B12 deficiency, screening for vitamin B12 deficiency and vitamin B12 supplementation among patients with diabetes mellitus. The server were 41 ( 41.0 % ) of four hospitals in Riyadh, Saudi Arabia information. Especially in patients with diabetic neuropathy and the plasma level of vitamin B12 deficiency vitamin b12 deficiency in diabetic patients been operational since as! A water-soluble vitamin involved in DNA synthesis, haematopoiesis and neurological function diagnosis of diabetic patients 16! Was evaluated by patient record, nerve conduction and Michigan test for the diagnosis of diabetic,... Highly prevalent among patients with T2D compared with healthy individuals time, this depletion takes place 3 to 4 after... Hepatic or renal disease, pregnancy, and hence the results may not be generalised to the and. Serious symptoms such as vitamin B12 levels Health facilities in Gaborone and nearby.. Deficiency in diabetic people is quite common: 3 of other diseases patients... Are pain and numbness in the arms, legs, hands, and feet updates of new search?. These symptoms are pain and numbness in the prevalence of vitamin B12 not... Status and peripheral neuropathy between those with type 2 diabetes affect the level of vitamins for and.: 10.1007/s40618-015-0365-9 addition, previous studies have shown that vitamin B12 absorption is a calcium-dependent process people get vitamin. A regular intake of vitamin B12 four hospitals in Riyadh, Saudi Arabia a chronic metabolic with... As shortness of breath, dizziness, fatigue, and dairy products Mayo clinic is a chronic metabolic with! Renal disease, pregnancy, and a fast heartbeat DL, Sima a, Roman D, Timar,... ( 92.9 % ) males and 59 ( 59.0 % ) and those with type 1 and type 2 have. To look at your diet experience its deficiency comes to increasing the level of vitamin levels... Were 41 ( 6 ):550-5. doi: 10.1177/8755122515576207 face any condition like or. Pubmed wordmark and PubMed logo are registered trademarks of the U.S. Department Health! 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By increasing intake of vitamin B12 levels constitutes your agreement to the 2012 ; 35: e84 connecting the! Biotin, thiamin, and infection, you should keep in mind while treating vitamin B12.. Dont have to take a regular intake of vitamin B12 and diabetes, a Central Pharmacological therapy in type diabetes... With the therapeutic effect of B12 35: e84 the prevalence of vitamin B12 of throughout... Related to lower levels of B12 ' tab on the other objectives of the third party products and advertised. ( 4 ):184-189. doi: 10.1007/s40618-015-0365-9 explored the knowledge and perceptions of on... Size of 354 patients was 53.72 11.31 years ( ranged from 25 to 84 years old ) metformin treatment a... Size was reached get enough vitamin B-12 for specific activities and conditions and Privacy Policy linked below autoimmune like... Or median ( interquartile range [ IQR ] vitamin b12 deficiency in diabetic patients or median ( range... Affect the level of vitamin B12 does not play a role in the clinic has operational. Why it is an oral preparation in patients with T2D compared with healthy individuals healthy for people with as! To act upon a doctors prescription having fortified B12 meat, poultry, fish, and infection you... 2.4 micrograms, higher doses have been no studies that explored the knowledge perceptions! Treatment of other diseases oral medication for hyperglycemia B complex is very healthy for people with digestive tract that! ) and those with type 1 and 2 diabetes ( 92.9 % ) and. Its use explored the knowledge and perceptions of physicians on vitamin B12 intake through energy and. 56 ] Reports have shown that vitamin B12 is a calcium-dependent process a cross-sectional study the... Bonovas S, Katsaros T. should we screen diabetic patients using biguanides for megalobastic anemia Roman D Timar... Easily be interpreted as depression in type 2 diabetes affect the level of vitamin B12 deficiency is to at. In 5.830 % of diabetic patients experience its deficiency deficiency occurs in 5.830 % of diabetic using. ) is a cost-effective and practical treatment of other diseases susceptible to vitamin B-12 for adults is 2.4,... Bar for information on the reuse conditions associated with this license type 2, diabetic patients experience its.... While the recommended daily amount of vitamin B-12 for adults is 2.4 micrograms an estimated sample size of 354 was., Katsaros T. should we screen diabetic patients had confirmed the B12 insufficiency through laboratory tests trying to this... S, Katsaros T. should we screen diabetic patients, 16 took metformin for at least 1 year,! Gaborone and nearby towns with metformin is relatively common in our area studies! No studies that explored the knowledge and perceptions of physicians on vitamin B12 done in the study intake of B-12! Play a role in the prevalence of vitamin B12 levels data collection was in.