Influence of methylcobalamin on the vitamin B12 level and manifestations of neuropathy in patients with type 2 diabetes mellitus and metformin-associated vitamin B12 deficiency
Journal Title: Міжнародний ендокринологічний журнал - Year 2019, Vol 15, Issue 4
Abstract
Background. Adverse side effect of metformin is disturbance in vitamin B12 metabolism associated with low serum vitamin B12 level. B12 hypovitaminosis is accompanied by peripheral neuropathy. The aim of the study was to determine the effectiveness of methylcobalamin (Diacobal preparation manufactured by Kusum Pharm LLC, Ukraine) in correcting vitamin B12 deficiency in diabetic patients with metformin-associated vitamin B12 deficiency, and to establish its effect on manifestations of diabetic neuropathy. Materials and methods. Thirty patients with type 2 diabetes mellitus and metformin-associated vitamin B12 deficiency (< 190 pg/ml) were examined. Duration of metformin administration was 6.1 years on average, the average dose was 2100 mg/day. Methylcobalamin was administered at a dose of 500 mg three times a day for three months. Determination of vitamin B12 content and assessment of neuropathy manifestations was carried out before and after the course of treatment. Results. After the course of treatment, it was found that the average content of vitamin B12 in the blood serum reached the reference values (312.4 ± 39.8 pg/ml). The positive effect of therapy on the severity of clinical manifestations of peripheral sensory motor neuropathy in the examined patients was revealed: in 17 (56.7 %) patients, the severity of numbness in feet significantly decreased, in 6 (20 %) persons, there was a complete disappearance of numbness. The intensity of the pain syndrome decreased in 19 (63.3 %) patients, the pain syndrome was completely removed in 3 (10 %) persons. Conclusions. The relationship between metformin and B12 hypovitaminosis has been confirmed. Diacobal is an effective and safe drug for the prevention and treatment of metformin-induced vitamin B12 deficiency and diabetic neuropathy.
Authors and Affiliations
V. I. Pankiv
Keywords
Related Articles
- EP ID EP630812
- DOI 10.22141/2224-0721.15.4.2019.174818
- Views 55
- Downloads 0
Non-classic congenital adrenal hyperplasia due to 21-hydroxylase deficiency: laboratory criteria for the diagnosis and control of treatment efficacy
Non-classic congenital adrenal hyperplasia (NCAH) due to 21-hydroxylase deficiency is one of the actual causes of hyperandrogenic manifestations at different age intervals. Timely diagnosis of the disease requires evalua...
Features of Some Hormonal Parameters in Patients with Perinatal Losses
The presence of mixed urogenital infections during pregnancy leads to violations in mother’s body: changes of homeostasis, depression of the immune response, induction of the autoimmune processes resulting in reduced res...
Influence of Graves’ Disease on Psychocognitive State of Children and Adults (Literature Review)
Psychoneurological changes in Graves’ disease are expressed in all patients at the early stages of the disease. Adolescents begin to do poorly in school, to skip school, there are changes in their behavior. Patients are...
Epidemiological Aspects of Diabetes Mellitus in Tashkent on the Basis of Register Data
The objective of research — an analysis of epidemiological aspects of diabetes mellitus (DM) type 1 and 2 in Tashkent. Materials and methods. Analysis of DM register was performed on the basis of the map registers in Ta...
Constitutional delay of growth and puberty in boys: review
The review focuses on the diagnosis, clinical and general therapeutic approach to constitutional growth and delayed puberty and hypogonadotrophic hypogonadism in men, which are difficult to distinguish. Clinical history...