Is vitamin B12 deficiency responsible for neuropathy in people with type 2 diabetes on metformin?
DOI:
https://doi.org/10.7439/ijbr.v10i8.5233Keywords:
Metformin, Vitamin B12 levels, Nerve conduction latency, Nerve conduction velocity, NeuropathyAbstract
Aims: Metformin is the first line monotherapy for achieving glycemic control in type 2 diabetes mellitus. However, metformin induces vitamin B12 malabsorption, which may increase the risk of developing vitamin B12 deficiency. The present study, therefore, aims at identifying the decrease in vitamin B12 levels in diabetics on metformin therapy and its effect on nerve conduction.
Methods: Sixty subjects, including 30 type 2 diabetics and 30 without diabetes were enrolled into the study and their nerve conduction parameters were assessed along with the evaluation of their serum vitamin B12 levels.
Results: Vitamin B12 levels were found to be deficient in diabetics on metformin as compared to age-matched, healthy controls (p<0.05). Nerve conduction latency was increased and conduction velocity decreased in diabetics in contrast to the controls (p<0.05). The decrease in vitamin B12 levels showed a significant negative correlation with the dose (r = -0.7, p<0.05) and duration (r = -0.5, p<0.05) of metformin exposure, whereas, the dose and duration of metformin therapy had no association with the nerve conduction parameters (p>0.1).
Conclusions: Although the vitamin B12 levels were deficient and nerve conduction parameters worsened in people with diabetes on metformin, but the worsened neuropathy cannot be attributed to the deficient vitamin B12 levels.
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