Assessment of Metformin Induced Vitamin-B12 Deficiency amongst Type-II Diabetic Patients Vis-À-Vis Evaluating the Quality of Life

ABSTRACT

Introduction: Metformin is the cornerstone medication inthe management of Type 2 diabetes mellitus with estimatesthat it is prescribed to 120 million patients with diabetesaround the world. Several studies reported that the long-termuse of metformin lowers vitamin -B12 levels and its clinicalmanifestation can be misdiagnosed as diabetic peripheralneuropathy. Thereby, the present study was undertaken toassess the vitamin-b12 deficiency in type II Diabetic patientswith long-term use of metformin, an association betweenvitamin B12 and peripheral neuropathy and evaluating thequality of life in (T2DM) patients.Material and Methods: A prospective observational casecontrol study was conducted at the outpatient and inpatientdepartments of RVM Hospital. Total 34 (controls) healthyvolunteers and 34 (cases) Type 2 diabetes patients usingmetformin for more than six months were recruited forthe study. Data was collected using designed profile form,structured questionnaires and venous blood samples werecollected in K2 EDTA vacutainers from the patients andcentrifuged at 1500 rpm for 10 minutes, settled plasma wastransferred into cryovials, estimating the parameters such asVitamin-B12, HbA1c and CBP. The statistical analysis wasdone using SPSS (v25) software.Results: The prevalence of serum vitamin B12 deficiency andborderline deficiency in T2DM patients is 20.5%, the meanHbA1C levels in our study T2DM subjects is < 9.07% which isshowing either poor control of diabetes and lack of compliancewith metformin medication. 83% of T2DM patients with 1-10years of metformin use resulted in Vitamin-B12 deficiency.Conclusion: Vitamin-B12 deficiency and Borderlinedeficiency prevalence in Type II Diabetes patients was foundto be slightly high in our study population when comparedto control subjects. The reliability test was done to evaluatetheir quality of life which concludes that the quality of life waspoor amongst the study participants. Considering the regularscreening of vitamin-B12 as a cost factor, the peripheral smearcan be done in T2DM patients on long-term metformin todetect macrocytic anaemia followed by biochemical analysisperiodically