Prevalence of Vitamin B12 Deficiency in Patients with Type II Diabetes Mellitus in Morang District
Abstract
Introduction: Type II Diabetes Mellitus is a significant global health concern that has become prevalent worldwide, and its impact on morbidity and mortality is substantial. Metformin is a commonly prescribed medication for type II diabetes that interferes with the absorption of vitamin B12 in the gastrointestinal tract, which leads to neurological issues in patients.
Objective: The aim of this study was to evaluate the vitamin B12 levels in Type II diabetic patients taking metformin at the Purbanchal University Teaching Hospital medical OPD.
Method: A quantitative, descriptive cross-sectional study was done from May 2022 to April 2023 at the medical outpatient department of Purbanchal University Teaching Hospital, Gothgaun, Morang. Non-probability purposive sampling was done to select 385 Type II diabetic patients on metformin for 12 months. A structured questionnaire was used for data collection, which was validated with the consultation of experts.
Result: It was found that the mean age (in years) with SD was 55.2±11.3; most of the respondents were female. The prevalence of low vitamin B12 was 21.8% among the study respondents. Diabetic patients on low vitamin B12 taking metformin were significantly associated with age over 50 years, a higher metformin dosage, a longer duration of use, and vegetarian dietary patterns.
Conclusion: These findings emphasize the importance of regular monitoring of vitamin B12 levels in Type II diabetes mellitus and prolonged metformin treatment to prevent potential complications
References
Nandeshwar S, Jamra V, Pal D. Indian diabetes risk score for screening of undiagnosed diabetic subjects of Bhopal city. Natl J Community Med. 2010, 1:176-7. https://njcmindia.com/index.php/file/article/view/2025
World Health Organization. Non-communicable Diseases in the South East Asia Region, World Health Organization, Geneva, Switzerland, 2021.
Poudel RR. Diabetes and endocrinology in Nepal. Indian journal of endocrinology and metabolism.vol. 18,1 (2014): 118-9. DOI:10.4103/2230-8210.126593.
Chelsea B, Stahr CR, Singh V, Plomondon R, Anderson V, Rasouli N. Should metformin remain the first-line therapy for treatment of Type II diabetes? Ther Adv Endocrinol Metab. 2021 Jan 13;12:2042018820 980225.. DOI:10.1177/2042018820980225
Black MM. Effects of vitamin B12 and folate deficiency on brain development in children. Food Nutr Bull. 2008, 29:S126-31. DOI:10.1177/156482650802 92S117
Medical NewsToday. Vitamin B12 deficiency: Symptoms, complications, and more. 2023.https:// www.medicalnewstoday.com/articles/172774.
American Diabetes Association. Standards of Medical Care in Diabetes-2017. Diabetes Care. 2017;42:S90– S102.
Yadav A, Jyoti S, Mehta RK, Parajuli SB. Vitamin B12 Deficiency among Metformin Treated Type II Diabetic Mellitus Patients Visiting the Department of Medicine of a Tertiary Care Centre. J Nepal Med Assoc 2023;61(266):861-3. DOI:10.31729/jnma.8340
Infante M, Leoni M, Caprio M, Fabbri A. Long-term metformin therapy and vitamin B12 deficiency: An association to bear in mind. World J Diabetes. 2021;12(7):916-931. DOI:10.4239/wjd.v12.i7.916 10. Ts R, Ranganathan RS, Raja MS, Srivastav PSS. Prevalence of vitamin B12 deficiency in Type II diabetes mellitus patients on metformin therapy. Curēus.2023.12;15(4):e37466. DOI: 10.7759/cureus. 37466
Aroda VR, Edelstein SL, Goldberg RB, Knowler WC, Marcovina SM, Orchard TJ, et al. Long-term metformin use and vitamin B12 deficiency in the Diabetes Prevention Program Outcomes study.Journal of Clinical Endocrinology and Metabolism/Journal of Clinical
Endocrinology & Metabolism 2016 . 1;101(4):1754–61. DOI:https://doi.org/10.1210/jc.2015-3754
Raizada N, Jyotsna VP, Sreenivas V, Tandon N. Serum vitamin B12 levels in Type II diabetes patients on metformin compared to those never on metformin: A cross-sectional study. Indian Journal of Endocrinology and Metabolism. 2017. 1;21(3):424. DOI: https://doi.org/10.4103/ijem.ijem_529_16
Verma VK, Nim RK, Singh PS, Kumar M. Vitamin b12 deficiency among vegetarian and non vegetarian iabetic population receving prolonged metformin based oral hypoglycemic agents therapy. Int J Adv Med. 2017 Aug; 4(4): 1150-1154. DOI: https://doi.org/ 10.18203/2349-3933.ijam20173249
Miyan Z, Waris N, MIBD. Association of vitamin B12 deficiency in people with Type II diabetes on metformin and without metformin: a multicenter study, Karachi, Pakistan. BMJ open diabetes research & care. 2020; 8(1), e001151. DOI: https://doi.org/10.1136/ bmjdrc-2019-001151
Reinstatler L, Qi YP, Williamson RS, Garn JV, Oakley GP Jr. Association of biochemical B₁ ₂ deficiency with metformin therapy and vitamin B₁ ₂ supplements: the National Health and Nutrition Examination Survey, 1999-2006. Diabetes Care. 2012;35(2):327-333. DOI: 10.2337/dc11-1582
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