Volume : 2, Issue : 6, JUN 2016

REVIEW: COBALAMINE STATUS IN TYPE 2 DIABETES MELLITUS PATIENTS ON METFORMIN THERAPY

Dr. Rekha Battalwar, Ms. Kajol Rathod

Abstract

Consistently all researches have shown that metformin therapy improves glycemic response and lowers HbA1c levels. Besides causing gastrointestinal disorders at higher doses metformin is strongly related to vitamin B12 malabsorbtion and deficiency. The dose is an independent predictor of deficiency of vitamin B12 and longer duration is associated with higher prevalence. Recommendation by certain authors state that there should be regular screening of Vitamin B12 and supplementation including folate and calcium for patients on long term metformin use, especially the elderly who are at a higher risk of vitamin B12 deficiency. But there is not enough evidence showing adverse effects of vitamin B12 deficiency in patients on metformin drug. Thus there is contradiction, stating supplementation might be of no use if health benefits are not observed. Thus there is need for more research on effects of vitamin B12 deficiency on long term metformin use and effective ways in which this deficiency can be treated. From a public health perspective, it is most relevant to investigate whether metformin use causes nutritional deficiencies and if posing a health risk to the population at exposure by translating evidence based recommendations. The purpose of this article is to review existing data regarding the effects of long term metformin usage as monotherapy or in combination therapy for glycemic control causing vitamin B12 deficiency.

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