How much vitamin B12 should a diabetic take? In the US, it is currently believed that adults with type 2 diabetes that are over 50 should take 2.4 g of synthetic vitamin B12 daily either in supplement form or in fortified food. Biochemical and clinical vitamin B12 deficiency has been demonstrated to be highly prevalent among patients with type 1 and type 2 diabetes mellitus. Diabetic patients should choose a diet that contains B12, else they will face a severe deficiency of this vitamin. Some people are vegetarian or vegan and dont eat animal products at all. However, older adults, vegetarians, vegans and people who have conditions that affect their ability to absorb vitamin B-12 from foods might benefit from the use of oral supplements. A hospital-based screening study using a panel of serum biomarkers, Seroprevalence of Helicobacter pylori and length of stay in a nursing home, Independent effect of vitamin B12 deficiency on hematological status in older Chinese vegetarian women, Prevalence and possible factors associated with anaemia, and vitamin B 12 and folate deficiencies in women of reproductive age in Pakistan: analysis of national-level secondary survey data, Evaluation of current criteria used to measure vitamin B12 levels, Cobalamin status and its relation with depression, cognition and neuropathy in patients with type 2 diabetes mellitus using metformin, Serum vitamin B12 levels in type 2 diabetes patients on metformin compared to those never on metformin: A cross-sectional study, Investigation of the vitamin B12 deficiency with peripheral neuropathy in patients with type 2 diabetes mellitus treated using metformin, Association of metformin, elevated homocysteine, and methylmalonic acid levels and clinically worsened diabetic peripheral neuropathy, The role of metformin on vitamin B12 deficiency: a meta-analysis review, Vitamin B12 deficiency and the lack of its consequences in type 2 diabetes patients using metformin, Neurologic aspects of cobalamin deficiency, Biomarkers of vitamin B12 status in NHANES: a roundtable summary, Reliability and validity of the modified Toronto clinical neuropathy score in diabetic sensorimotor polyneuropathy, Journal of Endocrinology, Metabolism and Diabetes of South Africa. Metformin therapy and assessment for vitamin B12 deficiency: is it necessary? Left untreated, a vitamin B-12 deficiency can lead to anemia, fatigue, muscle weakness, intestinal problems, nerve damage and mood disturbances. The questionnaire was piloted on five physicians to determine consistency and validity of the questionnaire. Higher doses of metformin and male sex were factors related to lower levels of vitamin B12. 2- Is Vitamin B complex healthy for diabetic patients? Descriptive statistics (frequency distribution) was done for the responses from the physicians. The patients on metformin had statistically lower Generally, vitamin B12 supplements start showing their effect after 48 to 72 hours of the initial dose. In a journal article on plant-based vitamin B12 sources, researchers have claimed that purple larval and mushrooms are very healthy and rich sources of B12. The mean duration of T2DM was 10.27 7.99 years (range of 2.026.0 years) and the mean duration of metformin use was 10.27 7.99 years (range of 2.026.0 years). The prevalence of vitamin B12 deficiency was 6.6%. J Pak Med Assoc. The clinic has been operational since 2011 as a referral centre for health facilities in Gaborone and nearby towns. Vitamin B12 deficiency is very serious because it leads to certain complications, including diabetes and anemia. Ko SH, Ahn YB, Song KH, Han KD, Park YM, Kim HS. Before There were 206 (56.7%) males and 157 (43.3%) females, and 337 (92.8%) were Saudis. In peripheral neuropathy, you will experience weakness, pain, and numbness in your hands, legs, and feet. Though vitamin B12 is commonly taken to increase energy levels, evidence showing that B12 supplements improve energy levels in people without a deficiency is lacking. Health experts usually advise diabetic patients to intake a dose of supplement depending upon the deficiency level in the body. You may also suffer from diabetic neuropathy due to a lack of vitamin B12. 1 The prevalence of vitamin B12 deficiency in diabetes mellitus Means RT Jr, et al. Ahmed M, Muntingh G, Rheeder P. Vitamin B12 deficiency in metformin-treated type-2 diabetes patients, prevalence and association with peripheral neuropathy BMC Pharmacol Toxicol. eCollection 2021. [25] There have been no studies that explored the knowledge and perceptions of physicians on vitamin B12 screening. Experiencing nausea, vomiting or diarrhea. 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. Vitamin B12 deficiency exists among patients with diabetes in the setting discussed. Biochemical and clinical vitamin B12 deficiency has been demonstrated to be highly prevalent among patients with type 1 and type 2 diabetes mellitus. the unsubscribe link in the e-mail. 2008;89:693S6S, 29. Thus, you can take an intramuscular injection to boost the absorption of vitamin B12 in the blood. The best way to treat low-level of vitamin B12 is by excessive intake of fortified bread, cereals, eggs, and milk. World J Clin Cases. (10.1136/bmj.c2181) https://www.micromedexsolutions.com. In addition, female patients had higher levels of vitamin B12 compared to men (coefficient: 49.1; CI 95%: 2.3-95). -Chronic treatment should be done with an oral preparation in patients with normal intestinal absorption. Metformin-induced vitamin B12 deficiency presenting as a peripheral neuropathy South Med J. 2021 Nov 26;9(33):10198-10207. doi: 10.12998/wjcc.v9.i33.10198. https://www.uptodate.com/contents/search. Estimation of Serum Vitamin B12 Levels Among the Elderly Population of Wardha City: A Cross-Sectional Study. (10.1210/jc.2015-3754) 2016;134:4739, 22. Find out what works best for you with this 60-sec expert-approved quiz and get your Klinio app. The average B12 level in the blood was 223pg/ml. eCollection 2022 Aug. Farland MZ, McPheeters CM, Renwick RC, Barlow PB, Williams JD, Keeble DS, Franks AS. While the recommended daily amount of vitamin B-12 for adults is 2.4 micrograms, higher doses have been found to be safe. Diabetes mellitus (DM) is a chronic metabolic disease with increasing prevalence worldwide. 1754-1761, 10.1210/jc.2015 The .gov means its official. There were 39 diabetic patients, 16 took metformin for at least 1 year. Of all the patients 17 were already considered to be deficient in B12. https://www.wolterskluwercdi.com/facts-comparisons-online/. Association of vitamin B12 deficiency and metformin use in patients with type 2 diabetes. Using an assumed proportion of 9.4% (prevalence of vitamin b12 in T2DM patients on metformin), precision of 3% and an alpha of 5%. Taking this diabetes drug might reduce your body's ability to absorb vitamin B-12. Kumthekar AA, Gidwani HV, Kumthekar AB. At the same time, its better to use natural dietary fibers like foods rich in vitamin B12. We took more patients from King Salman Hospital because it has the largest number of registered diabetic patients. IBM Micromedex. Russo GT, Giandalia A, Romeo EL, Scarcella C, Gambadoro N, Zingale R, Forte F, Perdichizzi G, Alibrandi A, Cucinotta D. J Endocrinol Invest. Vitamin B12 deficiency was defined by levels < 150pmol/l. Also, add a good amount of green leafy vegetables to your diet. Patients were given a single tablet of B vitamins containing 2.5 milligrams of folic acid, 25 milligrams of vitamin B6 and one milligram of vitamin B12 per day for 36 months or a matching placebo. Additional data, including demographic characteristics were collected. Diabetes Metab. Association between metformin and vitamin B12 deficiency in patients with type 2 diabetes: A systematic review and meta-analysis Diabetes Metab. An estimated sample size of 354 patients was calculated. This vitamin is essential for the proper functioning of the body. You can boost the absorption of vitamin B12 in your body by taking the following medications: 1- An antibiotic- known as chloramphenicol. 2016;12:35968, 4. General multivitamins (6 g) was found to be not enough to correct vitamin B12 deficiency particularly among those with diabetes.[8]. Weight Some error has occurred while processing your request. 2014;29:1394400, 18. Aust Fam Physician. A single copy of these materials may be reprinted for noncommercial personal use only. 1998-2023 Mayo Foundation for Medical Education and Research (MFMER). The mean duration of T2DM was 9.88 7.32 years (range: 135 years). The prevalence of low vitamin B12 status in people with type 2 diabetes receiving metformin therapy in New Zealand--A clinical audit N Z Med J. [Figure 1] A total of 51 (51.0%) order vitamin B12 testing supplementation only if they have symptoms of neuropathy, 9 (9.0%) if patients have anemia, 19 (19.0%) routinely order vitamin B12 testing, and 21 (21.0%) never prescribe vitamin B12 to their patients [Figure 2]. Endocrinol. He received his medical degree from University of Southern California and has been in practice around 8 years. CAN occurs when nerve damage affects the heart, which can be caused by prolonged hyperglycemia over several years in people with diabetes. There are a few different options as far as how you can treat your vitamin b12 deficiency if you are diabetic. https://www.uptodate.com/contents/search. Damio C, Rodrigues A, Pinheiro M, Cruz Filho R, Cardoso G, Taboada G, et al Prevalence of vitamin B12 deficiency in type 2 diabetic patients using metformin: A cross-sectional study Sao Paulo Med J. We also inquired about the use of metformin, antacids, oral contraceptives and calcium supplements. We chose the four hospitals according to availability of Vitamin B12 test. Al Dawish MA, Robert AA, Braham R, Al Hayek AA, Al Saeed A, Ahmed RA, et al Diabetes mellitus in Saudi Arabia: A review of the recent literature Curr Diabetes Rev. Clin Diabetes. Among those who took metformin for at least 1 year, 9 had vitamin B12 level < 240 pg/ml (56.2%); 23 diabetic patients did not get metformin and only 4 had vitamin B12 level < 240 pg/ml (17.4%) (P = 0.014). If you face a serious problem maintaining glucose, taking a vitamin B12 injection for almost 3 months will help you bring things in balance. People with diabetes taking metformin are at a higher risk of developing B12 deficiency, because this medication can reduce vitamin B12 absorption in the body . J. Clin. The first possible treatment option is to look at your diet. However, people who follow a vegetarian or vegan diet might be prone to deficiency because plant foods don't contain vitamin B-12. A skilled professional, Dr. Barnett holds certification from the American Board of Internal Medicine with a special focus on endocrinology, diabetes, and metabolism. 2017Last accessed on 2019 Jan 28 Available from: 3. HHS Vulnerability Disclosure, Help 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. Wolters Kluwer Health Cochrane Database Syst Rev. 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. The only way to recover from your condition of hyperhomocysteinemia is by taking a regular dose of vitamin B12, vitamin B6, and folic acid. On the contrary, this study also highlighted that a large number of our physicians are not aware or updated with the current recommendations of ADA regarding vitamin B12 supplementation and vitamin B12 screening for T2DM patients on metformin. 2017;354:16571, 19. [56] Reports have shown that vitamin B12 deficiency occurs in 5.830% of diabetic patients on long-term treatment with metformin. There were only 16 patients (4.4%) who had available serum vitamin B12 levels. Cited by lists all citing articles based on Crossref citations.Articles with the Crossref icon will open in a new tab. 2022 Mar 16;58(3):430. doi: 10.3390/medicina58030430. Fuchs HE, O'Connell K, Du M, Navarro SL, Brasky TM, Kantor ED. 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]). Encephale. Epub 2016 Apr 26. Abstract Background Metformin is first-line therapy for patients with diabetes. We conducted a cross-sectional study among patients attending Princess Marina diabetes clinic in Gaborone between July 2017 and October 2017. 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. Please refer to the 'Licensing' tab on the article menu bar for information on the reuse conditions associated with this license type. Folic acid with or without vitamin B12 for cognition and dementia. 2022 Aug;24(8):1423-1428. doi: 10.1111/dom.14734. 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