Prevalence of Vitamin B12 Insufficiency in Type 2 Diabetic patients on Metformin Therapy

Background: Type 2 DM is a syndrome with hallmark features of disturbance in metabolism of glucose, proteins and fats. The prevalence of diabetes has alarmingly risen in the past couple of decades, impacting a great socioeconomic stress especially in the developing countries. Aim: To determine the prevalence of B12 insufficiency in Type 2DM patients on metformin treatment Methodology: This survey was conducted over a period of 6 months (1-8-2019 to 1-2-2020) on T2 diabetic patients at Diabetic Clinic, Shaikh Zayed Hospital, Lahore. After informed written consent, demographic data of the enrolled patients were recorded. Patients were asking about history of metformin usage, dosage of metformin and duration of type 2 Diabetes Mellitus. A 5cc venous blood sample was drawn from the arm and stored at 4 C. Serums were extracted and Vitamin B12 level was determined using ELISA. Results: The mean age of patients was 50.02 +/- 9.14 years. There were 87(44.8%) males and 107(55.2%) females in this study. The participants had history of diabetes mellitus over 7.27 years. The mean HbA1c was 8.81 +/- 0.76. The included patients had history of intake of metformin over 6.10 years. There were 25(12.9%) patients taking 1000-1500mg metformin, 90(46.4%) were taking 1500-2000mg and 79(40.7%) were taking more than 2000 mg metformin daily. There were 66(34%) patients with normal BMI, 63(32.5%) were overweight and 65(33.5%) were obese. The mean serum B12 level was 225pg/ml. There were 101(52.1%) patients having vitamin B12 deficiency and 93(47.9%) patients had no vitamin B12 deficiency. Conclusion: It is concluded from this study that prevalence of B12 insufficiency is high among type II diabetic patients taking metformin.