Status of Vitamin B12 Level Among Type 2 Diabetes Mellitus Patients on Metformin Treatment Attending Diabetic Clinic of the Tikur Anbessa Specialized Hospital, Addis Ababa, Ethiopia
No Thumbnail Available
Date
2017-06
Authors
Journal Title
Journal ISSN
Volume Title
Publisher
Addis Ababa University
Abstract
Background: Metformin is a standard therapy, most commonly prescribed oral anti-hypergly-
cemic agent for individuals with type-2 diabetes (T2DM). Many studies also documented the
association between long-term metformin use and low vitamin B12 levels among individuals
with T2DM; however, metformin-induced vitamin B12 deficiency(VBD) prevalence estimates
showed large variation among studies. To the best of our knowledge, studies on the association
between long term metformin use and low vitamin B12 levels among individuals with T2DM are
not found in Ethiopia.
Objective: To determine the status of vitamin B12 level and risk factors associated with its
deficiency in patients with type 2 diabetes mellitus on metformin treatment attending diabetes
clinic of the Tikur Anbesa Specialized Hospital, Addis Ababa, Ethiopia.
Methods: Institutional based cross-sectional study was conducted from March 12/ 2017 to May
15/2017 at diabetes clinic of TASH. Convenient sampling method was used to include a total of
121 T2DM patients with and without metformin treatment. Blood samples were collected and
Vitamin B12 levels were determined by Cobas e411 analyzer by electro chemiluminescence
immunoassay. Neuropathy Total Symptom Score-6 questionnaire (NTSS-6 scores) was used to
compare severity of Peripheral neuropathy (PN) in both groups. VBD was defined as serum
concentration of <200 pg/dl. NTSS-6 scores >6 is considered to have PN. Finally data was
entered and analyzed through SPSS version 20 computer software packages.
Results: From the total of 121 study participants serum B12 levels were low(<200pg/ml) in
15(21.1%) T2DM patients with metformin (n=71) as compared to 2 patients (4.0%) without
metformin treatment(n=50). Mean B12 level with metformin was found to be 331.58 pg/ml(±
134.48) as compare to those without metformin 482.23pg/ml(± 235.24), the difference was
stastically significant with p value <0.001.The factors that interfered with serum B12 levels
were duration of diabetes, dose and duration of metformin use. Vitamin B12 levels and NTSS-6
scores were not correlated (Spearman’s rho =0.021, P=0.819).
Conclusion: Among patients with T2DM treated with metformin had low serum B12 levels than
patients not treated by metformin with significant effect of metformin dose and duration on B12
levels. The deficiency was not associated with peripheral neuropathy.
Keywords: Type 2 Diabetes Mellitus, Status, Vitamin B12 deficiency, Metformin, neuropathy
Description
Keywords
Type 2 Diabetes Mellitus, Status, Vitamin B12 deficiency, Metformin, Neuropathy