Vitamin B12 deficiency in turkish patients with Type 2 Diabetes Mellitus

Objective: Type 2 diabetes (T2DM) disease and related changes in blood parameters bring essential health risks. This study was carried out to determine the frequency of vitamin B12 deficiency in T2DM patients, the effect of B12 deficiency on blood glucose, HbA1c control and lipid parameters, and the B12 level in diabetes patients using metformin. Material and Methods: 287 patients with T2DM who were followed up in the Endocrinology department of Istanbul Training and Research Hospital were evaluated. After the patients called for control had fasted for 8 hours, blood tests were performed, and biochemical parameters were determined with standard laboratory techniques. Vitamin B12 <180 mg/dl was accepted as a deficiency, and patients were divided into groups regarding vitamin B12 deficiency. The chemiluminescence method was used to determine serum Vitamin B12 levels. Data were analyzed using SPSS version 22.0 (IBM Corporation, Armonk, NY, USA). Results: A total of 287 T2DM patients were included in the study. B12 deficiency is present in 29.8% of T2DM patients. Vitamin B12 values were found to be lower in patients with T2DM using metformin (280.2 pg /ml ±151.06 pg/ml, p<0.05); however, lower vitamin B12 values did not have a significant effect on blood sugar control (p=0,3), and hypovitaminosis Vitamin B12 was associated with elevated hypertriglyceridemia (p=0,03). Conclusion: According to the current study, serum vitamin B12 level was not associated with blood glucose and HbA1c; a relationship was found between vitamin B12 deficiency and higher hypertriglyceridemia. A significant proportion of T2DM patients using metformin had lower levels of vitamin B12 compared to T2DM patients not using metformin. Vitamin B12 levels should be monitored regularly in the follow-up of patients with T2DM using metformin.

[1]  Wismandari Wisnu,et al.  The efficacy of vitamin B12 supplementation for treating vitamin B12 deficiency and peripheral neuropathy in metformin-treated type 2 diabetes mellitus patients: A systematic review. , 2022, Diabetes & metabolic syndrome.

[2]  Jiecan Zhou,et al.  Gut Microbiota and Antidiabetic Drugs: Perspectives of Personalized Treatment in Type 2 Diabetes Mellitus , 2022, Frontiers in Cellular and Infection Microbiology.

[3]  D. Bell Metformin‐induced vitamin B12 deficiency can cause or worsen distal symmetrical, autonomic and cardiac neuropathy in the patient with diabetes , 2022, Diabetes, obesity & metabolism.

[4]  J. Alhaji Vitamin B12 Deficiency in Patients with Diabetes on Metformin: Arab Countries , 2022, Nutrients.

[5]  Meng Xue,et al.  Nutraceuticals use and type 2 diabetes mellitus. , 2022, Current opinion in pharmacology.

[6]  Xiaoru Zhang,et al.  The independent association between vitamin B12 and insomnia in Chinese patients with type 2 diabetes mellitus: a cross-sectional study , 2022, Nutrition & Diabetes.

[7]  Ling-ling Zhu,et al.  Serum vitamin B12 levels and glycemic fluctuation in patients with type 2 diabetes mellitus , 2022, Therapeutic advances in endocrinology and metabolism.

[8]  G. Krishnan,et al.  Prevalence of Vitamin B12 Deficiency and its Associated Factors among Patients with Type 2 Diabetes Mellitus on Metformin from a District in Malaysia , 2020, Journal of the ASEAN Federation of Endocrine Societies.

[9]  2. Classification and Diagnosis of Diabetes: Standards of Medical Care in Diabetes—2020 , 2019, Diabetes Care.

[10]  Hidong Kim,et al.  Measurement of Vitamin B12 and Serum Methylmalonic Acid Levels: Role of Stepwise Cascade Testing in Diagnosing Vitamin B12 Deficiency , 2018, Blood.

[11]  H. Bilo,et al.  Vitamin B12 deficiency and the lack of its consequences in type 2 diabetes patients using metformin. , 2013, The Netherlands journal of medicine.

[12]  R. Obeid,et al.  Advanced glycation end products overload might explain intracellular cobalamin deficiency in renal dysfunction, diabetes and aging. , 2011, Medical hypotheses.

[13]  K. Chow,et al.  Risk factors of vitamin B(12) deficiency in patients receiving metformin. , 2006, Archives of internal medicine.

[14]  B. Rutkowski,et al.  Is there any relationship between lipids and vitamin B levels in persons with elevated risk of atherosclerosis? , 2003, Medical science monitor : international medical journal of experimental and clinical research.

[15]  A. Spungen,et al.  Increased intake of calcium reverses vitamin B12 malabsorption induced by metformin. , 2000, Diabetes care.

[16]  John S Yudkin,et al.  Association of systolic blood pressure with macrovascular and microvascular complications of type 2 diabetes (UKPDS 36): prospective observational study , 2000, BMJ : British Medical Journal.

[17]  C. I. Pogson,et al.  Regulation of carnitine palmitoyltransferase activity by malonyl-CoA in mitochondria from sheep liver, a tissue with a low capacity for fatty acid synthesis. , 1985, The Biochemical journal.

[18]  Rebecca S. Williamson,et al.  The National Health and Nutrition Examination Survey, 1999–2006 , 2011 .

[19]  P. Keeling,et al.  The dinoflagellates Durinskia baltica and Kryptoperidinium foliaceum retain functionally overlapping mitochondria from two evolutionarily distinct lineages , 2007, BMC Evolutionary Biology.

[20]  E. Nexo,et al.  Diagnosis and treatment of vitamin B12 deficiency--an update. , 2006, Haematologica.