Type 2 diabetes mellitus (DM) is a prevalent global health problem and is on a constant rise, especially in middle- and low-income countries. Vitamin B12 malabsorption is one of the reported side effects of metformin. Our study aims to assess the correlation of B12 deficiency in type 2 diabetics and to determine if this deficiency may have any direct effect on their health that requires immediate attention.
Metformin and Vitamin B12
Patients with type 2 diabetes mellitus often take metformin for its anti-hyperglycemic action. Metformin acts on liver cells to increase glucose utilization and decrease blood glucose levels in patients. As a side effect, decreased absorption of vitamin B12 has been reported from studies on animals, but not yet studied in humans. Our study aimed to assess whether patients with type 2 diabetes mellitus treated with metformin have low levels of vitamin B12. We measured serum vitamin B12 levels as well as methylmalonic acid (MMA) levels in participants aged 40 years or older who had been taking metformin for more than three months.
Effectiveness of Metformin
Metformin is an effective medication for type 2 DM, but it can cause malabsorption of vitamin B12, a common deficiency in diabetic patients. Vitamin B12 deficiencies are related to low dietary intake, malabsorption syndromes, or other medical conditions. Proper supplementation is required to prevent negative effects on health. However, there has been little research on assessing and treating vitamin B12 deficiency caused by metformin. Doctors need to ensure that their diabetic patients are receiving enough vitamins through diet or supplements while they are on metformin. A healthy diet includes foods that contain vitamin B9 (folate), which our body needs along with vitamin B12 to properly process it.
Metformin Side Effects
Metformin is a medication commonly used to treat type 2 diabetes. A common side effect of metformin is vitamin B12 malabsorption, which can potentially cause vitamin B12 deficiency. In some cases, people have reported serious health problems as a result of vitamin B12 deficiency caused by metformin use. Some are even allergic to metformin, so that would be another side effect.
Risk Factors Associated with Metformin Use
We used patient demographics, prescription information from a physician database, laboratory data, and medical history to determine patients’ risk factors for vitamin B12 deficiency. Older age (≥ 50 years) or female gender were associated with an increased prevalence of vitamin B12 deficiency in patients taking metformin as well as other types of anti-diabetic drugs. Additionally, higher Charlson Comorbidity Index scores predicted a greater prevalence of vitamin B12 deficiency in type 2 diabetics. Higher serum levels of homocysteine also increased patients’ risk for developing B12 deficiency while lower values correlated with increased mortality due to cardiovascular disease.
Progression of DM
People who have had diabetes for a long time often develop DM complications, such as heart disease, nerve damage, or eye problems. This usually happens 10-20 years after diagnosis. People with type 1 diabetes can develop many of these same complications. The process is known as diabetic neuropathy. Treatment may help delay or slow some complications from developing, but there is no cure for DM yet. So it’s important to take care of your health and try to delay or prevent them from developing if you can.
A total of 200 patients with type 2 diabetes mellitus were examined to evaluate the correlation between vitamin B12 deficiency and the incidence of DM. A total of 100 diabetic patients without vitamin B12 deficiency served as controls. The risk factors for vitamin B12 deficiency in diabetics, especially metformin use, were analyzed using Pearson’s Chi-square test. A level of 5% was considered statistically significant at p<0.05 level. Data were analyzed using IBM SPSS software version 20 (IBM Corporation, Armonk, NY).