Metformin Induced Vitamin B12 deficiency: A Cross sectional study. Untangling the connection

Area of Science:

• Endocrinology
• Neurology
• Clinical Pharmacology

Background:

• Metformin is a first-line treatment for type 2 diabetes, known for efficacy and tolerability.
• Long-term metformin use is associated with Vitamin B12 deficiency, potentially causing peripheral neuropathy and anemia.
• Current guidelines for screening and treating metformin-induced Vitamin B12 deficiency are not well-established.

Purpose of the Study:

• To investigate the association between metformin use and Vitamin B12 deficiency.
• To examine the link between metformin use and peripheral neuropathy.
• To highlight the need for improved clinical guidelines regarding Vitamin B12 monitoring in metformin users.

Main Methods:

• A prospective, observational, cross-sectional study was conducted at a tertiary care hospital.
• Serum Vitamin B12 levels were analyzed in study participants.
• The Michigan Neuropathy Screening Instrument was used to assess for peripheral neuropathy.

Main Results:

• A statistically significant association was found between metformin use and Vitamin B12 deficiency.
• The average duration of metformin use leading to Vitamin B12 deficiency was 13.6 years.
• Metformin use was also significantly associated with the development of peripheral neuropathy.

Conclusions:

• Long-term metformin use commonly leads to Vitamin B12 deficiency and peripheral neuropathy.
• There is a need for targeted guidelines on screening and treating Vitamin B12 deficiency in patients on metformin.
• Physicians and patients require increased education, particularly for at-risk populations like the elderly and vegetarians.