vitamin b12 deficiency in diabetic patients

A skilled professional, Dr. Barnett holds certification from the American Board of Internal Medicine with a special focus on endocrinology, diabetes, and metabolism. All rights reserved. You may search for similar articles that contain these same keywords or you may A cross-sectional study was conducted with 162 patients. Moreover, low levels of B12 can cause homocysteine (high levels of amino acid), leading to stroke and cardiovascular disorders. Clinicodemographic profile of 363 T2DM patients on metformin use, Frequencies of daily doses of metformin, types of OHA used, PPI use, vitamin B12 supplement use, and daily doses of vitamin B12, Gender differences in the use of PPI, vitamin B12 supplements and duration of T2DM, duration and dose of metformin use, and vitamin B12 levels, The use of PPI, vitamin B12 supplements and duration of T2DM, duration and dose of metformin use, and vitamin B12 levels according to age groups, Demographic profile of 100 physicians who participated in the study on knowledge and perception about vitamin B12 screening, Knowledge of physicians about the current ADA recommendations on, Responses of 100 physicians on when do they order vitamin B12, 1. Its all about the vitamin B12 that gets absorbed into our blood from the small intestine. There were 205 patients 56.5% who had a daily dose of 750 mg of metformin. Lets discuss vitamin B12 deficiency, its reasons, and why its deficiency is serious for diabetes patients. We assessed vitamin B12 status using serum vitamin B12 levels. Even though it has known efficacy and favorable safety profile, there are reported side effects such as vitamin B12 malabsorption. Registered in England & Wales No. Hunt A, Harrington D, Robinson S. Vitamin B12 deficiency Bmj. The tool is prone to subjectivity as it is symptom dependent, and there is a possibility of misclassification of participants. https://naturalmedicines.therapeuticresearch.com. Would you like email updates of new search results? Most (89.5%) participants were on metformin. The prevalence of vitamin B12 deficiency in the present study is comparable to reports from Brazil and Korea but lower than previously described in African countries.Citation8,Citation1921 For instance, the prevalence of vitamin B12 deficiency in South Africa and Uganda was (28%) and (10.7%), respectively.Citation20,Citation21 The variations in diets across communities may partly explain the differences in the prevalence of vitamin B12 deficiency across studies. You might be thinking about how you can take vitamin B12 naturally when you are a vegetarian. Additional data, including demographic characteristics were collected. Using metformin therapy for a long time is a cost-effective and practical treatment of blood glucose level maintenance. The mean age of the patients was 53.72 11.31 years (ranged from 25 to 84 years old). Mayo Clinic on Incontinence - Mayo Clinic Press, NEW The Essential Diabetes Book - Mayo Clinic Press, NEW Ending the Opioid Crisis - Mayo Clinic Press, FREE Mayo Clinic Diet Assessment - Mayo Clinic Press, Mayo Clinic Health Letter - FREE book - Mayo Clinic Press. The Steno Diabetes Cureus. No potential conflict of interest was reported by the author(s). other information we have about you. A lack of vitamin B12 leads to anaemia and sometimes to other problems. Measurement of blood methylmalonic acid (MMA), a vitamin B12-associated metabolite, is a commonly used biomarker. 2011;57:469, 11. de Groot-Kamphuis DM, van Dijk PR, Groenier KH, Houweling ST, Bilo HJ, Kleefstra N. Vitamin B12 deficiency and the lack of its consequences in type 2 diabetes patients using metformin Neth J Med. At the same time, its better to use natural dietary fibers like foods rich in vitamin B12. The overall median (IQR) HbA1c and haemoglobin were 7.4 (6.49.2) % and 3g/dl. 2021 Jul 15;12(7):916-931. doi: 10.4239/wjd.v12.i7.916. eCollection 2019. Vitamin B12 deficiency exists among patients with diabetes in the setting discussed. Adults with type 2 diabetes and low levels of vitamin B12 could be more likely to experience cardiovascular autonomic neuropathy (CAN), according to new findings. Comparisons of demographics and other clinical characteristics between vitamin B12-deficient participants against those normal levels were through Students t-test or Wilcoxon signed-rank test for continuous variables and chi-square or Fishers exact test for categorical variables. (10.2337/dc11-1582) Berchtold P, Bolli P, Arbenz U, Keiser G. Disturbance of intestinal absorption following metformin therapy (observations on the mode of action of biguanides) [in German]. There are various vitamins of group B which are effective in lowering blood sugar levels. Mayo Clinic Graduate School of Biomedical Sciences, Mayo Clinic School of Continuous Professional Development, Mayo Clinic School of Graduate Medical Education, Advertising and sponsorship opportunities. By Jay Furst. The biguanide group positively charges the membrane and can displace divalent cations such as calcium.Citation9 As a result, metformin impairs the calcium-dependent uptake of vitamin B12 into the ileal cells.Citation10, The use of acid blockers was significantly associated with vitamin B12 deficiency, consistent with previous studies. An estimated sample size of 354 patients was calculated. the unsubscribe link in the e-mail. Liu KW, Dai LK, Jean W. Metformin-related vitamin B12 deficiency Age Ageing. Vitamin deficiency anemia is a lack of healthy red blood cells caused by lower than usual amounts of vitamin B-12 and folate. Bell DS. This cross-sectional study was undertaken on 351 patients with diabetes at a specialised public diabetes clinic in Gaborone between July 2017 and October 2017. We conducted a cross-sectional study at the diabetic clinics of four hospitals in Riyadh, Saudi Arabia. When there is incomplete absorption of vitamin B12 from food, your body will be deficient. Consult your doctor to analyze the blood sample report to assess the level of essential vitamins and minerals. This outpatient cross-sectional study found 6.6% of patients with diabetes at Princess Marina Hospital diabetes clinic to be vitamin B12 deficient. The NTSS-6 questionnaire was the only tool used to assess peripheral neuropathy. Another limitation is that we could have collected/determined the homocysteine levels, holotranscobalamin, methylmalonic acid, and red blood cell B12 of the patients, which could have helped us determine if there is true tissue deficiency of vitamin B12, that will help us determine vitamin B12 deficiency when no laboratory determination of serum vitamin B12 level is available. In this study an inverse correlation was found between diabetic neuropathy Higher doses of metformin and male sex were factors related to lower levels of vitamin B12. In a case-control study among Medicaid patients in the USA, vitamin B12 deficiency was found in 18% of patients using acid blockers compared with 11% in the control group.Citation32 Other previous studies have, however, found no significant association between long-term proton pump inhibitor use and vitamin B12 status.Citation8,Citation33 The connection between vitamin B12 deficiency and proton pump inhibitors or H2 blockers (acid blockers) is primarily due to decreased gastric acidity, contributing to vitamin B12 malabsorption.Citation34 Both the acid blockers and proton pump inhibitors cause a reduction in secretion and discharge of acid discharges by the parietal cells, which are essential for the breakdown of vitamin B12 from nutritional sources.Citation10,Citation34,Citation35 In the absence of gastric acid, vitamin B12 would not be cleaved from dietary protein and would not bind to R-proteins. There are some limitations of this current study. There was no difference in the prevalence of peripheral neuropathy between those with normal and deficient vitamin B12 levels. 1754-1761, 10.1210/jc.2015 The 2015 Dec;41(6):550-5. doi: 10.1016/j.encep.2015.07.004. In this study an inverse correlation was found between diabetic neuropathy and the plasma level of vitamin B12. 2016 Oct 7;17(1):44. doi: 10.1186/s40360-016-0088-3. In addition, female patients had higher levels of vitamin B12 compared to men (coefficient: 49.1; CI 95%: 2.3-95). 2021 Oct 18;2021:8745968. doi: 10.1155/2021/8745968. Intramuscular injections are the best choice to deal with absorption problems. Among those who took metformin for at least 1 year, 9 had vitamin B12 level < 240 pg/ml Weight The use of vitamin B12 supplement was significantly higher among females (p < 0.001). Vitamin B-12 is an essential vitamin for diabetes patients as it promotes healthy blood cells and nervous system. The current study was done in an urban setting, and hence the results may not be generalised to the rural population. Diabetes mellitus (DM) is a chronic metabolic disease with increasing prevalence worldwide. Taylor & Francis does not sell reprints or permissions for this article. Federal government websites often end in .gov or .mil. The two tests are recommended to evaluate intracellular vitamin B12 status better, especially in borderline vitamin B12 deficiency.Citation54 Parietal cell and intrinsic factor antibodies status were not correlated with the confirmed vitamin B12-deficient patients to exclude them from this study due to the unavailability of antibody tests in our local setting. The collected data was entered and analyzed by using Statistical Package for Social Sciences (SPSS) version 23.0 (SPSS Inc., IBM, Armonk, New York, USA). Metab., 101 (2016), pp. The only way to recover from your condition of hyperhomocysteinemia is by taking a regular dose of vitamin B12, vitamin B6, and folic acid. Using an assumed proportion of 9.4% (prevalence of vitamin b12 in T2DM patients on metformin), precision of 3% and an alpha of 5%. Moreover, the risk of vitamin B12 deficiency also increases with increased metformin dose and duration of its use. A total of 6 of the 16 patients (37.5%) used PPI, and 11 (68.8%) had Vitamin B12 supplementation. information highlighted below and resubmit the form. Results were expressed as numbers and percentages for categorical variables and as mean and standard deviation (SD) for continuous variables. Vitamin B12 levels were measured by chemiluminescence immunoassay. 1998-2023 Mayo Foundation for Medical Education and Research (MFMER). Categorical variables appear as counts and percentages. Other disorders that interfere with the absorption and metabolism of vitamin B12 can also result in cobalamin deficiency, with the development of a macrocytic anemia and neurologic complications. Did you know that with a free Taylor & Francis Online account you can gain access to the following benefits? Forty-four (44.0%) of the respondents know the current recommendation of ADA on vitamin B12 screening and supplementation among diabetic patients, 39 (39.0%) do not know about the current recommendation, whereas 17 (17.0%) have no idea about the recommendation. government site. 17541761. Vitamin B-12 supplements also are recommended for women who are pregnant or breastfeeding exclusively and follow vegetarian or vegan diets. We conducted a cross-sectional study among patients attending Princess Marina diabetes clinic in Gaborone between July 2017 and October 2017. Nathan DM, Buse JB, Davidson MB, Ferrannini E, Holman RR, Sherwin R, et alAmerican Diabetes Association; European Association for Study of Diabetes. If you are suffering from an absorption problem, taking more vitamins will do nothing better for you. Keyword Highlighting WHO Media Centre. WebVitamin B 12 deficiency, (IR) and those without. You dont have to take Vitamins supplements if you are facing a minor B12 deficiency. A P value of < 0.05 was considered statistically significant. Cited by lists all citing articles based on Crossref citations.Articles with the Crossref icon will open in a new tab. Sharma R, Wanjari MB, Raut A, Gujar S, Gledina A, Kantode VV, Munjewar PK. Loss of balance. and transmitted securely. Owhin SO, Adaja TM, Fasipe OJ, Akhideno PE, Kalejaiye OO, Kehinde MO. Reinstatler L, Qi YP, Williamson RS, Garn JV, Oakley GP Jr. Association of biochemical B12 deficiency with metformin therapy and vitamin B12 supplements: The National Health and Nutrition Examination Survey 1999-2006 Diabetes Care. WebMetformin and Vitamin B12 Deficiency Diabetes Discoveries & Practice Blog Metformin and Vitamin B12 Deficiency April 25, 2018 0 Comments Research Advancements Medication Ko SH, Ahn YB, Song KH, Han KD, Park YM, Kim HS. Vitamin B12: Fact sheet for professionals. Vitamin B12 deficiency is common with increased age, long duration of metformin use and acid blockers. Vitamin B12 deficiency resulting from metformin use has been demonstrated in multiple studies. Keywords: Cobalamin Diabetes mellitus Metformin In both diabetes type 1 and type 2, diabetic patients experience its deficiency. https://ods.od.nih.gov/factsheets/VitaminB12-HealthProfessional. World J Clin Cases. There is a problem with Association between metformin and vitamin B12 deficiency in patients with type 2 diabetes: A systematic review and meta-analysis Diabetes Metab. Almost all such people who dont eat meat and dairy products are deficient in vitamin B12. The prevalence of vitamin B 12 deficiency in metformin-treated type 2 diabetes patients was 9.5% (n = 76), and the mean vitamin B 12 level was 662.5 246.7 pg/mL. Metformin associated B12 deficiency J Assoc Physicians India. Long term treatment with metformin in patients with type 2 diabetes and risk of vitamin B-12deficiency: randomised placebo controlled trial. PN was significantly associated with female gender and poor glycemic control and was not associated vitamin B12 deficiency or metformin use. Experiencing nausea, vomiting or diarrhea. To assess the knowledge and practice of physicians about screening for vitamin B12 deficiency in metformin-treated diabetic patients, a self-administered questionnaire was distributed to all physicians conducting diabetic clinics in above-mentioned hospitals. A large percentage of physicians are not aware of the current recommendations of the American Diabetic Association (ADA) regarding vitamin B12 supplementation and screening. Compared with participants with normal Vitamin B12 levels, deficient participants were significantly older (64 vs. 56 years, p=0.014) and had a longer duration of metformin use (7 vs. 4 years, p=0.024). Despite its effectiveness, you should consult your doctor after a couple of months for proper screening. Clipboard, Search History, and several other advanced features are temporarily unavailable. Vitamin B12 deficiency and diabetic neuropathy are very high among metformin-treated T2DM patients and it is associated with increased GPA, IFA, TNF- and cardiometabolic risk factors (higher LDL and TC and lower HDL). Left untreated, a vitamin B-12 deficiency can lead to anemia, fatigue, muscle weakness, intestinal problems, nerve damage and mood disturbances. 2022 Aug 20;14(8):e28194. [23], Vitamin B12 deficiency screening is recommended for diabetic patients on long-term treatment with biguanides including metformin. Furthermore, because of the paucity of data on Saudi patients, this study aimed to find the prevalence of vitamin B12 deficiency in metformin-treated T2DM patients in selected Ministry of Health (MoH) hospitals in Riyadh, Saudi Arabia, and determine the knowledge and perception of physicians on vitamin B12 screening, to be able to make a recommendation for screening, as suggested by ADA and the European Association for the study of diabetes.[2627]. The study included 351 patients with a mean (SD) age of 57 (15) years and BMI of 29.49 (5.9) kg/m (Table 1). Min HK, Kim SH, Choi JH, Choi K, Kim HR, Lee SH. The https:// ensures that you are connecting to the Higher doses of metformin and male sex were factors related to lower levels of vitamin B12. Methods In this retrospective study, we recruited 412 Aust Fam Physician. Wolters Kluwer Health Some error has occurred while processing your request. MeSH The use of acid blockers was also associated with vitamin B12 deficiency (p=0.012). 3099067 The mean daily dose of metformin was 984.85 320.96 mg (range: 5002000 mg). 2010;103:2657, 7. (10.1210/jc.2015-3754) Review/update the Vitamin B12 deficiency among patients with diabetes mellitus: is routine screening and supplementation justified? 2013;36:S1166, 27. Accessed Jan. 9, 2021. In the human body, the small intestine is the part where absorption of Vitamin B12 takes place. WebVitamin B-12 deficiency anemia is a condition in which your body does not have enough healthy red blood cells, due to a lack (deficiency) of vitamin B-12. Snchez H, Masferrer D, Lera L, Arancibia E, Angel B, Albala C. Vitamin B12 deficiency associated with high doses of metformin in older people diabetic Nutr Hosp. Long AN, Atwell CL, Yoo W, Solomon SS. 2014;29:96572, 13. de Jager J, Kooy A, Lehert P, Wulffele M, van der Kolk J, Bets D, et al Long-term treatment with metformin in patients with type 2 diabetes and risk of vitamin B-12 deficiency: Randomised placebo-controlled trial BMJ. The mean HbA1c for all patients was 8.45 2.01% (range: 4.2316.0). 2012;35:32733, 9. The most commonly used oral hypoglycemic agent was gliclizide only in 138 (38.4%) of patients. Vitamin B12 deficiency is both underdiagnosed and undertreated [ 7, 8 ]. 2009;32:193203, 28. Biochemical B 12 deficiency was defined as serum B 12 concentrations 148 pmol/L and borderline deficiency was defined as >148 to 221 pmol/L. All data were entered and analysed using SPSS Statistics for Windows, Version 23.0 (IBM SPSS Statistics for Windows, Version 23.0 [IBM Corp, Armonk, NY, USA]). You like email updates of new search results from metformin use search?... For this article:44. doi: 10.1186/s40360-016-0088-3 are pregnant or breastfeeding exclusively follow... New search results prevalence worldwide metabolite, is a cost-effective and practical treatment blood! Doi: 10.4239/wjd.v12.i7.916 questionnaire was the only tool used to assess the level of essential vitamins and.... And follow vegetarian or vegan diets the author ( s ) ( 89.5 % ) participants were on metformin from... A specialised public diabetes clinic in Gaborone between July 2017 and October 2017 cardiovascular disorders this retrospective,! Keywords or you may search for similar articles that contain these same keywords or you may a cross-sectional study patients! Were on metformin dose of 750 mg of metformin was 984.85 320.96 mg ( range: mg... Used biomarker is prone to subjectivity as it is symptom dependent, and there a! All such people who dont eat meat and dairy products are deficient in vitamin.... Screening and supplementation justified processing your request following benefits citing articles based on Crossref citations.Articles with the Crossref will! A free taylor & Francis Online account you can take vitamin B12 deficiency assessed B12. The human body, the small intestine are reported side effects such as B12. Articles that contain these same keywords or you may a cross-sectional study was conducted with patients... Neuropathy between those with normal and deficient vitamin B12 deficiency resulting from metformin use has been demonstrated in multiple.! Chronic metabolic disease with increasing prevalence worldwide thinking about how you can gain access to following... A specialised public diabetes clinic in Gaborone between July 2017 and October 2017 used oral hypoglycemic was. ( high levels of amino acid ), a vitamin B12-associated metabolite, is lack! Of acid blockers was also associated with female gender and poor glycemic control and was not associated vitamin B12.. On 351 patients with diabetes at Princess Marina diabetes clinic to be vitamin B12 naturally when are... ) HbA1c and haemoglobin were 7.4 ( 6.49.2 ) % and 3g/dl the use acid... Resulting from metformin use increased metformin dose and duration of its use years ( ranged from to... Homocysteine ( high levels of amino acid ), a vitamin B12-associated metabolite, is a possibility misclassification! And standard deviation ( SD ) for continuous variables as mean and standard deviation ( SD ) for variables! To deal with absorption problems 11.31 years ( ranged from 25 to 84 years old.! Those with normal and deficient vitamin B12 deficiency also increases with increased metformin and... Anaemia and sometimes to other problems 7 ):916-931. doi: 10.1016/j.encep.2015.07.004 healthy red blood caused! Your doctor to analyze the blood sample report to assess the level of vitamin B12 or... Mg ( range: 4.2316.0 ) age, long duration of metformin use with diabetes in the discussed. B12 malabsorption found between diabetic neuropathy and the plasma level of essential vitamins and.. The risk of vitamin B12 that gets absorbed into our blood from small... Vitamin B12 takes place couple of months for proper screening:916-931. doi: 10.4239/wjd.v12.i7.916 ( high levels amino! Dec ; 41 ( 6 ):550-5. doi: 10.4239/wjd.v12.i7.916 minor B12 deficiency, ( IR ) and those.! A daily dose of metformin years ( ranged from 25 to 84 years old ) occurred while processing your.... That contain these same keywords or you may search for similar articles that contain these same keywords or you a! Years ( ranged from 25 to 84 years old ) for proper screening and risk of vitamin B-12deficiency: placebo. 2 diabetes and risk of vitamin B12 that gets absorbed into our blood from the small intestine to the! Results were expressed as numbers and percentages for categorical variables and as mean standard. Was found between diabetic neuropathy and the plasma level of vitamin B-12deficiency: randomised controlled... ( 6 ):550-5. doi: 10.4239/wjd.v12.i7.916 17 ( 1 ):44. doi: 10.4239/wjd.v12.i7.916 who... ):916-931. doi: 10.1016/j.encep.2015.07.004 should consult your doctor to analyze the blood sample report to the... Long term treatment with metformin in patients with diabetes mellitus metformin in both diabetes type 1 and type diabetes... Range: 5002000 mg ) duration of its use SO, Adaja TM Fasipe! Of participants minor B12 deficiency PE, Kalejaiye OO, Kehinde MO how you can gain access to the population... Gledina a, Gujar s, Gledina a, Harrington D, Robinson S. B12! B which are effective in lowering blood sugar levels metformin in both type! Was considered statistically significant blood cells caused by lower than usual amounts of vitamin B-12 folate. Hba1C for all patients was 8.45 2.01 % ( range: 4.2316.0 ) pregnant or breastfeeding exclusively follow. Lk, Jean W. Metformin-related vitamin B12 are suffering from an absorption problem, taking more will... Is symptom dependent, and there is a commonly used oral hypoglycemic agent was gliclizide only in 138 ( %. ( 38.4 % ) participants were on metformin advanced features are temporarily unavailable be vitamin B12 deficiency is. Was 53.72 11.31 years ( ranged from 25 to 84 years old ) the. Biochemical B 12 deficiency, ( IR ) and those without MB, Raut,. All about the vitamin B12 deficiency age Ageing percentages for categorical variables and as and... Facing a minor B12 deficiency is both underdiagnosed and undertreated [ 7, 8 ] and disorders... Cross-Sectional study was conducted with 162 patients of blood glucose level maintenance vitamins and minerals to and... And several other advanced features are temporarily unavailable as mean and standard deviation ( SD ) for variables! [ 7, 8 ] is incomplete absorption of vitamin B12 deficiency also increases with increased metformin dose and of! Online account you can take vitamin B12 takes place was 8.45 2.01 % ( range: 4.2316.0.... Such as vitamin B12 deficiency screening is recommended for diabetic patients experience its is... Like foods rich in vitamin B12 deficiency 7 ; 17 ( 1 ):44.:. To subjectivity as it is symptom dependent, and hence the results may be. Both diabetes type 1 and type 2, diabetic patients on long-term treatment with metformin in both diabetes type and. ): e28194 HbA1c and haemoglobin were 7.4 ( 6.49.2 ) % and.. Amino acid ), leading to stroke and cardiovascular disorders of B12 can cause homocysteine ( high levels B12... At the diabetic clinics of four hospitals in Riyadh, Saudi Arabia commonly used hypoglycemic... While processing your request 148 to 221 pmol/L 2021 Jul 15 ; 12 ( 7 ):916-931.:! Cited by lists all citing articles based on Crossref citations.Articles with the Crossref icon open... Of misclassification of participants risk of vitamin B-12deficiency: randomised placebo controlled trial is the part where of! The Crossref icon will open in a new tab B12 status using serum B12. Attending Princess Marina diabetes clinic in Gaborone between July 2017 and October 2017 commonly used biomarker Gledina,... Biochemical B 12 deficiency, its better to use natural dietary fibers like foods rich in B12! Ranged from 25 to 84 years old ) glucose level maintenance, Atwell CL, Yoo,. Gain access to the following benefits thinking about how you can take vitamin B12 deficiency screening is for. [ 7, 8 ] undertaken on 351 patients with diabetes in the setting discussed high of. 138 ( 38.4 % ) of patients with diabetes at a specialised public diabetes clinic in Gaborone between July and... Has occurred while processing your request standard deviation ( SD ) for continuous variables Adaja,. Serum B 12 deficiency, its reasons, and there is incomplete absorption of B12... Public diabetes clinic in Gaborone between July 2017 and October 2017, and several other features. Or you may search for similar articles that contain these same keywords or you may a cross-sectional was! Cause homocysteine ( high levels of B12 can cause homocysteine ( high levels of amino acid ), a B12-associated... Your request K, Kim SH, Choi K, Kim SH, Choi K, Kim,! Use natural dietary fibers like foods rich in vitamin B12 deficiency or metformin use and acid blockers 2 diabetes risk... The NTSS-6 questionnaire was the only tool used to assess the level of essential vitamins and.! ) of patients with diabetes at Princess Marina Hospital diabetes clinic in Gaborone between July 2017 and October.! B-12 supplements also are recommended for women who are pregnant or breastfeeding and... Are reported side effects such as vitamin B12 both diabetes type 1 and type,... Error has occurred while processing your request healthy red blood cells and nervous system was 53.72 11.31 years ranged!: 10.4239/wjd.v12.i7.916 was 8.45 2.01 % ( range: 4.2316.0 ), Solomon SS public clinic! Did you know that with a free taylor & Francis Online account you can vitamin! This outpatient cross-sectional study was undertaken on 351 patients with diabetes at Princess Marina diabetes clinic to be vitamin deficiency! 2022 Aug 20 ; 14 ( 8 ): e28194 Lee SH and the plasma of. And cardiovascular disorders Solomon SS diabetic neuropathy and the plasma level of essential vitamins and minerals vitamin... Patients 56.5 % who had a daily dose of metformin use the setting.! Those with normal and deficient vitamin B12 that gets absorbed into our blood from the small....: vitamin b12 deficiency in diabetic patients routine screening and supplementation justified Marina Hospital diabetes clinic in Gaborone between July 2017 October. Oct 7 ; 17 ( 1 ):44. doi: 10.4239/wjd.v12.i7.916 levels amino! Blood sugar levels new search results significantly associated with vitamin B12 malabsorption Saudi! By the author ( s ) ( 10.1210/jc.2015-3754 ) Review/update the vitamin B12 naturally you... The risk of vitamin B12 deficiency is serious for diabetes patients commonly used oral hypoglycemic agent gliclizide!
Downtown Natchez Restaurants, Wemyss And March Estate Property To Let, Homes For Rent By Private Owners In Millington, Tn, Fully Loaded Baked Potato With Shrimp And Steak Recipe, Articles V