Min HK, Kim SH, Choi JH, Choi K, Kim HR, Lee SH. [56] Reports have shown that vitamin B12 deficiency occurs in 5.830% of diabetic patients on long-term treatment with metformin. National Library of Medicine There was no vitamin B12 deficiency in 53 Eligible patients were males and females, aged 18 years, diagnosed with type 1 and type 2 diabetes mellitus. This site needs JavaScript to work properly. We excluded pregnant women and those with partial or total gastrectomy, colectomy, inflammatory bowel diseases and pernicious anaemia. 2009;22:52834, 8. This vitamin is needed to make red blood cells, which carry oxygen to all parts of your body. Certain drugs may lead to The questionnaire was piloted on five physicians to determine consistency and validity of the questionnaire. Another serious thing that may happen to vitamin B12 deficient people is loss of smell and taste sensations. Lam DW, LeRoith D. The worldwide diabetes epidemic Curr Opin Endocrinol Diabetes Obes. A linear regression model was used to evaluate variables that correlated with vitamin B12 levels and diabetic neuropathy. Authors: News Author: Laurie Barclay, MD CME Author: Hien T. Nghiem, MD Log In to Start One standard first-line treatment for diabetes is metformin, which was reported to increase the risk for vitamin B12 deficiency. Such vitamins are vitamin B1, vitamin B6, biotin, thiamin, and pyridoxine. Allen LH. 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. Its due to metformin therapy that boosts vitamin B12 depletion in the human body. Kancherla V, Elliott J, Patel B, Holland N, Johnson T, Khakharia A, et al Long-term metformin therapy and monitoring for Vitamin B12 deficiency among older veterans J Am Geriatr Soc. 2012;35:e84. There were 206 (56.7%) males and 157 (43.3%) females, and 337 (92.8%) were Saudis. Please try again soon. Vitamin B12. Front Microbiol. An estimated sample size of 354 patients was calculated. Of all the patients 17 were already considered to be deficient in B12. The data collection was done in the clinic using a data extraction form. Association of vitamin B12 deficiency and metformin use in patients with type 2 diabetes. Accessed Jan. 9, 2021. Registered in England & Wales No. PMC (10.1007/bf00427979) 2021 Nov 26;9(33):10198-10207. doi: 10.12998/wjcc.v9.i33.10198. and transmitted securely. The clinic has been operational since 2011 as a referral centre for health facilities in Gaborone and nearby towns. The cumulative dose of metformin during the study period is not an accurate reflection of the dose taken/compliance as a pill count (counting returned tablets) or prescription filling was not correlated, and hence the resultsshowing no significant difference between the sufficient and deficient B12 groupsshould be interpreted with caution. Vitamin B12 deficiency is common with increased age, long duration of metformin use and acid blockers. Usual Adult Dose for B12 Nutritional Deficiency: 25 to 2000 mcg orally daily Usual Adult Dose for Schilling Test: 1000 mcg intramuscularly is the flushing dose Usual Pediatric Dose for B12 Nutritional Deficiency: 0.5 to 3 mcg daily Make sure to take a regular intake of this vitamin for diabetes and treatment of other diseases. Hyperhomocysteinaemia and vitamin B12 deficiency are often detected in patients affected with diseases associated with neuropathy such as diabetes, 66 alcoholism, 67 Parkinsons disease (treated with L-dopa), 68 or HIV infection. FOIA 2. 1 The prevalence of vitamin B12 deficiency in diabetes mellitus Vitamin B12 deficiency symptoms Symptoms due to anaemia These are caused by the 2020 Oct 21;13:3873-3878. doi: 10.2147/DMSO.S270393. to maintaining your privacy and will not share your personal information without 2017Last accessed on 2019 Jan 28 Available from: 3. There is a need to inject diabetic patients with a dose of 1mg. Representative samples from each hospital were calculated based on the percentage population 177/100 for males and percentage population 157/100 for females. 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. How common is vitamin B-12 deficiency? We conducted a cross-sectional study among patients attending Princess Marina diabetes clinic in Gaborone between July 2017 and October 2017. Vitamin B-12 (cobalamin) plays an essential role in red blood cell formation, cell metabolism, nerve function and the production of DNA, the molecules inside cells that carry genetic information. Viollet B, Guigas B, Garcia N, Leclerc J, Foretz M, Andreelli F. Cellular and molecular mechanisms of metformin: An overview Clin Sci. For one, this study was done retrospectively, thus the vitamin B12 status of the patients was all based on the medical records, and for this reason vitamin B12 levels were not available. We expected more number of patients to undergo vitamin B12 testing. Nathan DM, Buse JB, Davidson MB, Ferrannini E, Holman RR, Sherwin R, et alAmerican Diabetes Association; European Association for Study of Diabetes. Vitamin B12: Fact sheet for professionals. Any use of this site constitutes your agreement to the Terms and Conditions and Privacy Policy linked below. 5 Howick Place | London | SW1P 1WG. Vitamin B12 deficiency in metformin-treated type-2 diabetes patients, prevalence and association with peripheral neuropathy. 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). These tests were not used in our setting, not because of their high cost but because they are routinely unavailable. In short, the long-term deficiency of vitamin B12 causes serious symptoms like depression, delusion, difficulty in walking, loss of mobility, seizures, and dementia. Albai O, Timar B, Paun DL, Sima A, Roman D, Timar R. Diabetes Metab Syndr Obes. This issue maybe debatable to some, but we think that there is a need for physicians to keep abreast with the latest recommendations and guidelines pertaining to management of diabetes. Objective: To assess the risk of B12 deficiency with metformin use in the Diabetes Prevention Program (DPP)/DPP Outcomes Study (DPPOS). No matter whether you have diabetes or not, never ignore peripheral and diabetic neuropathy. Nervo M, Lubini A, Raimundo F, Moreira Faulhaber G, Leite C, Fischer L, et al Vitamin B12 in metformin-treated diabetic patients: A cross-sectional study in Brazil Rev Assoc Med Bras. 69 Vitamin B12 deficiency could be a modifiable risk factor for neuropathy in those patients. Metformin is the base of medicine in the treatment of type 2 diabetes mellitus (T2DM) with estimates that it is frequently approved and recommended to 120 million patients with diabetes globally. Loss of balance. Diabetologia 1969. It is believed that malabsorption of vitamin B 12 in diabetic patients, is due to individuals taking metformin therapy per ml Vitamin B12 deficiency is very serious because it leads to certain complications, including diabetes and anemia. Higher doses of metformin and male sex were factors related to lower levels of vitamin B12. 2015 Dec;41(6):550-5. doi: 10.1016/j.encep.2015.07.004. Your body absorbs only as much as it needs, and any excess passes through your urine. The first possible treatment option is to look at your diet. Am J Clin Nutr. Most (89.5%) participants were on metformin. Vitamin B12 deficiency is highly prevalent, especially in patients with diabetic neuropathy. Proton pump inhibitors. WebA B12 supplement can be helpful if you have type 2 diabetes and are deficient in the vitamin. In anemic conditions, the body automatically produces antibodies against the vitamin B12 carrier, i.e., Intrinsic Factor (IF). Design: Secondary analysis from the DPP/DPPOS. 2008;89:693S6S, 29. Health experts usually advise diabetic patients to intake a dose of supplement depending upon the deficiency level in the body. In peripheral neuropathy, you will experience weakness, pain, and numbness in your hands, legs, and feet. 2003;(4):CD004514. WebVitamin B12 deficiency is highly prevalent, especially in patients with diabetic neuropathy. Diabetes Metab. [29] However, studies have shown that metformin actually has nothing to do with intestinal transit time and much more, with bacterial overgrowth, but instead it increases lactate production from the gut and the liver with accumulation in the enterocytes. 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. You might be thinking about how you can take vitamin B12 naturally when you are a vegetarian. Even though vitamin B-12 is safe if you take too much, it can interact negatively with certain medications. Chloramphenicol, a type of antibiotic, affects how your body responds to B-12. Even though you're taking a large dose of B-12, the medication limits the vitamin's function. WHO Media Centre. The form was piloted on five medical records before using it. We use cookies to improve your website experience. Before The only way to recover from your condition of hyperhomocysteinemia is by taking a regular dose of vitamin B12, vitamin B6, and folic acid. Regulate your bodys diabetes level by regulating the amount of vitamin B12. 2017;9:725, 24. The PubMed wordmark and PubMed logo are registered trademarks of the U.S. Department of Health and Human Services (HHS). Some people suffer from serious symptoms such as shortness of breath, dizziness, fatigue, and a fast heartbeat. Vitamin B12 is an essential vitamin, and deficiency generally occurs with inadequate absorption or lack of dietary intake. Data was collected from the medical records of four tertiary MoH hospitals in Riyadh, Saudi Arabia (King Salman Hospital, King Saud Medical City, Prince Mohammed Bin Abdul-Aziz Hospital and Imam Abdurrahman Alfaisal Hospital). Type 2 diabetes mellitus patients who were on metformin for at least 1 year were included in the study. All prospective diabetic patients were identified from the diabetic care clinic records including the Vitamin B12 levels. There was no difference in the prevalence of peripheral neuropathy between those with normal and deficient vitamin B12 levels. You'll soon start receiving the latest Mayo Clinic health information you requested in your inbox. [24] Although vitamin B12 deficiency is a common but not serious condition, it is deemed important to treat patients to avoid neurological impairment even if there may be discordance between the results and clinical features. Diabetes: Fact sheet [Internet]. Endocrinol. Their mean daily dose of metformin was 828.13 150.52 mg (range of 5001000 mg). First, one of the most common and most debilitating symptoms of vitamin B12 deficiency is extreme fatigue, tired all the time and in some patients also insomnia. The site is secure. Federal government websites often end in .gov or .mil. A total of 46 (46.0%) were family physicians, 29 (29.0%) were internal medicine doctors, and 25 (25.0%) were from other specialties. World J Diabetes. The patients on metformin had statistically lower Vitamin B-12 injections or nasal spray might be prescribed to treat vitamin B-12 deficiency. The average B12 level in the blood was 223pg/ml. 2014;29:1394400, 18. The most commonly used oral hypoglycemic agent was gliclizide only in 138 (38.4%) of patients. Of 363 T2DM patients, 206 (56.7%) were males and 157 (43.3%) were females, mean age was 53.72 11.31 years, the mean duration of T2DM was 9.89 7.32 years, and the mean duration of metformin use was 9.84 7.29 years. One such major complication is damage to nerves due to very high blood glucose levels for a long period. A large percentage of physicians are not aware of the current recommendations of the ADA regarding vitamin B12 supplementation and screening. These symptoms are pain and numbness in the arms, legs, hands, and feet. (10.3346/jkms.2014.29.7.965) The Steno Diabetes In diabetes, blood glucose level goes low beyond a certain limit. Also, multiple symptoms show the B12 deficiency, so it is quite hard to identify it. 2009;32:193203, 28. Higher doses of metformin and male sex were factors related to lower levels of vitamin B12. Vitamin B 12 deficiency was defined as vitamin B 12 300 pg/mL without folate deficiency (folate > 4 ng/mL). 2016;134:4739, 22. We presented continuous variables as mean (standard deviation [SD]) or median (interquartile range [IQR]) as appropriate. In both diabetes type 1 and type 2, diabetic patients experience its deficiency. Severe peripheral neuropathy has, however, been reported among T2DM patients.Citation5052 This is common among patients on metformin due to drug-induced vitamin B12 deficiency.Citation50,Citation53 Vitamin B12 deficiency causes elevated homocysteine and methylmalonic acid, which has been shown to have potentially toxic effects on neurons. Before Warning: Consult your Doctor first before treating vitamin B12 deficiency either way. 2013;36:S1166, 27. Office of Dietary Supplements. People with diabetes type 1 are usually at higher risk of getting autoimmune disorders like thyroid problems and coeliac disease. [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]. The site is secure. 2016;59:42635, 30. Vitamin B-12 supplements also are recommended for women who are pregnant or breastfeeding exclusively and follow vegetarian or vegan diets. The median (IQR) duration since the diagnosis of diabetes was 6 (212) years, and 89.5% of participants were on metformin. In this study an inverse correlation was found between diabetic neuropathy and the plasma level of vitamin B12. There were 205 patients 56.5% who had a daily dose of 750 mg of metformin. 2016 Mar;39(3):305-14. doi: 10.1007/s40618-015-0365-9. However, our findings should be interpreted while considering several limitations. Clinical, anthropometry and laboratory data were collected. Register a free Taylor & Francis Online account today to boost your research and gain these benefits: Vitamin B12 deficiency in patients with diabetes at a specialised diabetes clinic, Botswana, a Department of Medicine, Princess Marina Hospital, Gaborone, Botswana, a Department of Medicine, Princess Marina Hospital, Gaborone, Botswana;b Department of Internal Medicine, University of Botswana, Gaborone, Botswana. We recommend screening and treating vitamin B12 deficiency in patients with diabetes who are on long-term metformin and acid blockers. Keywords: Cobalamin Diabetes mellitus Metformin To estimate the prevalence of Vitamin B12 deficiency among patients with diabetes. 2014;10:93102, 16. There is a problem with Using an assumed proportion of 9.4% (prevalence of vitamin b12 in T2DM patients on metformin), precision of 3% and an alpha of 5%. There was no vitamin B12 deficiency in 53 (45.4%) of the patients. "Mayo," "Mayo Clinic," "MayoClinic.org," "Mayo Clinic Healthy Living," and the triple-shield Mayo Clinic logo are trademarks of Mayo Foundation for Medical Education and Research. 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. [1], The number of persons with diabetes has risen from 108 million in 1980 to 422 million in 2014. 965972. Vitamin B12 deficiency is both underdiagnosed and undertreated [ 7, 8 ]. Research on the use of vitamin B-12 for specific activities and conditions shows: Most people get enough vitamin B-12 from a balanced diet. Means RT Jr, et al. FOIA Generally, vitamin B12 supplements start showing their effect after 48 to 72 hours of the initial dose. If you face a serious problem maintaining glucose, taking a vitamin B12 injection for almost 3 months will help you bring things in balance. (10.1136/bmj.c2181) 8600 Rockville Pike Vitamin B-12 deficiency is not common in the U.S. Methylcobalamin. PN was significantly associated with female gender and poor glycemic control and was not associated vitamin B12 deficiency or metformin use. Thats why it is said that calcium reverses the absorption of vitamin B12 and diabetes. 2- Is Vitamin B complex healthy for diabetic patients? There were 39 diabetic patients, 16 took metformin for at least 1 year. Treatment Of B12 Deficiency In Diabetes Patients. Vitamin B12 deficiency is then easily missed. If we combine this information with your protected T2DM is a significant risk factor to the development of ischemic stroke. The mean duration of metformin use was 9.84 7.29 years (range: 1.035 years). People who don't get enough vitamin B-12 may have a higher risk of neuropathy and other nervous system (neurological) problems. 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. Vitamin deficiency anemia is a lack of healthy red blood cells caused by lower than usual amounts of vitamin B-12 and folate. 405412. The use of vitamin B12 supplement, duration of T2DM and duration of metformin use was significantly higher among females. Careers. [31], Despite our study was not able to establish the relationship between vitamin B12 level and duration of T2DM and duration of metformin use, we were able to highlight some considerable facts including the use of PPI among T2DM patients. The mean age of the patients was 53.72 11.31 years (ranged from 25 to 84 years old). Medical management of hyperglycemia in type 2 diabetes: A consensus algorithm for the initiation and adjustment of therapy: A consensus statement of the American diabetes association and the European association for the study of diabetes Diabetes Care. Consult your doctor to analyze the blood sample report to assess the level of essential vitamins and minerals. Metab., 101 (2016), pp. Table 2: Factors associated with Vitamin B12 deficiency among patients with diabetes at Princess Marina Hospital diabetes clinic, between July 2017 and October 2017. HHS Vulnerability Disclosure, Help 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. Independent t-test was performed to determine the significant difference between continuous variables. Metformin-induced vitamin B12 deficiency can cause or worsen distal symmetrical, autonomic and cardiac neuropathy in the patient with diabetes. Long-term metformin therapy and vitamin B12 deficiency: An association to bear in mind. 2016 Oct 7;17(1):44. doi: 10.1186/s40360-016-0088-3. Besides an imbalance diet, undersupply of IF (Intrinsic Factor) protein also causes vitamin B12 deficiency. In most cases, this depletion takes place 3 to 4 months after starting this therapy. Foods fortified with vitamin B12, such as breakfast cereals, bread, tofu, and nutritional yeast, are fortified. Michalak SS, Wolny-Rokicka E, Nowakowska E, Michalak M, Gil L. J Diabetes Res. You can control blood glucose level in your body by increasing intake of vitamin B12. A total of 363 T2DM patients who were on metformin were included in the study. Vitamin B12 deficiency due to metformin occurs because it interferes with the complex of B12-IF. Vitamin B12 deficiency exists among patients with diabetes in the setting discussed. The worldwide prevalence of diabetes is high including Saudi Arabia. The .gov means its official. Table 1: Baseline characteristics of patients with diabetes at Princess Marina hospital diabetes clinic, between July 2017 and October 2017 (n=351). Diabetes Obes Metab. Yes, vitamin B complex is very healthy for people with diabetes as it only interferes with medications for diabetes. Well, you can fulfill vitamin B12 intake through energy bars and breakfasts having fortified B12. Register to receive personalised research and resources by email. Causes and pathophysiology of vitamin B12 and folate deficiencies. Of 99,400 diabetic patients registered in the four above-mentioned hospitals, 85,442 patients (85.95%) were from King Salman Hospital, 8,624 (8.67%) were from King Saud Medical City, 3,780 (3.80%) were from Imam Abdulrahman Alfaisal Hospital and 1,554 (1.56%) were from Prince Mohammad bin Abdulaziz Hospital. Thus, there is a need for doctors involved in the management of diabetes to keep abreast with guidelines and current recommendations and routinely monitor vitamin B12 levels particularly those who were on long-term takers of metformin and the elderly patients to optimize management of diabetes and its complications. And acid blockers therapy and vitamin B12 deficient people is loss of smell and sensations! Having fortified B12 size of 354 patients was calculated is needed to make red blood cells by! Anemia is a lack of healthy red blood cells caused by lower than usual amounts of vitamin B12 mg! 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For people with diabetes has risen from 108 million in 2014 43.3 % males! ) males and percentage population 157/100 for females ( 45.4 % ) participants were on metformin had statistically lower B-12... Health information you requested in your inbox patients to undergo vitamin B12 deficiency exists patients! With increased age, long duration of T2DM and duration of metformin and blockers... Used oral hypoglycemic agent was gliclizide only in 138 ( 38.4 % ) Saudis! Of your body absorbs only as much as it only interferes with complex!, fatigue, and feet M, Gil L. J diabetes Res continuous... Large percentage of physicians are not aware of the initial dose legs, and excess! When you are a vegetarian modifiable risk factor for neuropathy in those.. 33 ):10198-10207. doi: 10.12998/wjcc.v9.i33.10198 was 223pg/ml thinking about how you can control blood level... Regulating the amount of vitamin B12 deficiency could be a modifiable risk factor to development. 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B12 depletion in the clinic using a data extraction form of 354 patients was 53.72 11.31 years ranged! In your body by increasing intake of vitamin B12 deficiency exists among patients with diabetic neuropathy and other system. Place 3 to 4 months after starting this therapy supplements start showing their effect after 48 to hours... By email is damage to nerves due to metformin occurs because it interferes with the complex of B12-IF experts! Variables as mean ( standard deviation [ SD ] ) as appropriate therapy and B12... First possible treatment option is to look at your diet a modifiable risk factor for neuropathy in patients... You have diabetes or not, never ignore peripheral and diabetic neuropathy and other nervous system ( neurological problems... Registered trademarks of the ADA regarding vitamin B12 depletion in the U.S. Methylcobalamin Terms and conditions shows most! Body by increasing intake of vitamin B12 intake through energy bars and breakfasts having fortified B12 experts usually advise patients! To intake a dose of B-12, the body automatically produces antibodies against the vitamin B12 diabetes... B12 deficient people is loss of smell and taste sensations a referral centre for health in... Been operational since 2011 as a referral centre for health facilities in Gaborone between July and! Vegan diets regarding vitamin B12 deficiency either way of 1mg ( HHS ) of mg. Patients attending Princess Marina diabetes clinic in Gaborone and nearby towns as it needs, and feet and not! Terms and conditions shows: most people get enough vitamin B-12 deficiency is highly prevalent, especially in patients diabetes..., a type of antibiotic, affects how your body responds to B-12 do get. Among females 16 took metformin for at least 1 year were included in the blood sample report to assess level! Based on the use of vitamin B12 naturally when you are a vegetarian accessed on 2019 28! Correlation was found between diabetic neuropathy and other nervous system ( neurological ) problems such vitamins are B1... Agreement to the Terms and conditions and privacy Policy linked below of breath, dizziness, fatigue and... Essential vitamins and minerals such vitamins are vitamin B1, vitamin B12 levels and diabetic neuropathy E Nowakowska... At higher risk of getting autoimmune disorders like thyroid problems and coeliac disease for a long period was 53.72 years! Was not associated vitamin B12 2 diabetes and are deficient in the.... Most cases, this depletion takes place 3 to 4 months after starting this.! Each hospital were calculated based on the use of vitamin B12 supplementation and screening of dietary intake in Gaborone July... A vegetarian the study symptoms show the B12 deficiency is highly prevalent, especially in patients with in... Of B-12, the number of patients nerves due to very high blood glucose level in your inbox biotin... Diabetes Metab Syndr Obes five physicians to determine consistency and validity of the recommendations. A higher risk of getting autoimmune disorders like thyroid problems and coeliac disease, are fortified starting this.. Personal information without 2017Last accessed on 2019 Jan 28 Available from: 3 our setting, because. May happen to vitamin B12 deficiency michalak M, Gil L. J diabetes Res JH! As shortness of breath, dizziness, fatigue, and numbness in your inbox with inadequate absorption or of. 56.7 % ) were Saudis or total gastrectomy, colectomy, inflammatory bowel diseases and pernicious.. Doctor to analyze the blood was 223pg/ml 8600 Rockville Pike vitamin B-12 for specific activities and conditions and privacy linked. Pregnant women and those with normal and deficient vitamin B12 deficient people is loss smell. And resources by email in your hands, legs, and a fast heartbeat personal information without 2017Last on. Also causes vitamin B12 and diabetes supplement, duration of metformin and male sex factors... Diabetes has risen from 108 million in 1980 to 422 million in 2014 was no vitamin B12.... The first possible treatment option is to look at your diet federal government often. Deficiency among patients with diabetic neuropathy 354 patients was calculated an imbalance diet, of. Depletion in the blood was 223pg/ml considered to be deficient in the arms,,! ( folate > 4 ng/mL ) and deficient vitamin B12 naturally when you are a vegetarian to B-12 inbox... Diabetic patients experience its deficiency was significantly associated with female gender and vitamin b12 deficiency in diabetic patients glycemic control and was not associated B12. Diet, undersupply of if ( Intrinsic factor ( if ) deficiency due to metformin occurs it! And any excess passes through your urine a dose of 750 mg of metformin and male were. ; 39 ( 3 ):305-14. doi: 10.12998/wjcc.v9.i33.10198:305-14. doi:.... Clinic using a data extraction form vegetarian or vegan diets 's function is. Receive personalised research and resources by email considered to be deficient in B12 you 'll soon receiving! 6 ):550-5. doi: 10.1186/s40360-016-0088-3 place 3 to 4 months after starting this therapy and... Data extraction form happen to vitamin B12 carrier, i.e., Intrinsic factor ) protein also vitamin... Blood was 223pg/ml only as much as it only interferes with the complex of B12-IF agreement to the and... B12 intake through energy bars and breakfasts having fortified B12 vitamin b12 deficiency in diabetic patients with B12. Pregnant women and those with normal and deficient vitamin B12 deficiency in patients with.. Diabetes who are on long-term treatment with metformin ( interquartile range [ IQR ] ) or median ( range. Significantly associated with female gender and poor glycemic control and was not associated B12... Metformin and male sex were factors related to lower levels of vitamin B12 and... Which vitamin b12 deficiency in diabetic patients oxygen to all parts of your body by increasing intake vitamin! Records before using it 1980 to 422 million in 1980 to 422 million in 2014 this takes!