Metformin Use and Vitamin B<SUB>12</SUB> Deficiency in Patients with Type-2 Diabetes Mellitus
Journal Title: MVP Journal of Medical Sciences - Year 2016, Vol 3, Issue 1
Abstract
Metformin is commonly used oral hypoglycaemic agent in the treatment of type-2 Diabetes Mellitus (DM). One of the important side effect of long term metformin therapy is malabsorption of vitamin B12 which could lead to megaloblastic anemia and peripheral neuropathy. Therefore annual screening of serum vitamin B12 level or serum methylmalonic acid (MMA)/serum homocysteine level should be done in cases taking metformin for more than four to five years with average dose of >1g per day, even in the absence of haematological or neurological abnormalities. However, as the incidence of type-2 DM is increasing, cost of annual measurement of vitamin B12 level also increases. Considering cost factor for annual screening, vitamin B12 supplementation appears to be more cost effective approach rather than annual screening for routine prophylaxis. Routine vitamin preparations available in the market may contain less amount of B12 and hence are not of much therapeutic use in treatment of B12 deficiency due to Metformin. Hence there is a need to look for higher doses of approximately 500-2000μg/day.
Authors and Affiliations
Singh Jeetendra, Baheti Tushar
Study of Diagnostic Importance of Adenosine Deaminase (ADA) Level in Pleural Effusions
Introduction: Pleural effusion is the abnormal accumulation of fluid in the pleural space. TB is the most common cause of pleural effusion worldwide (30-60%). The pleural fluid activity of adenosine deaminase (ADA) is on...
To Study Bacteriological Profile and Antibiotic Sensitivity Pattern in Cases of Neonatal Sepsis
Objective: To study the bacteriological profile and sensitivity pattern in cases of Neonatal sepsis at 12 bedded Neonatal Intensive Care Unit (NICU). Methods: This was a prospective study of neonates admitted to our NICU...
Evisceration of Small Intestine through Thigh Due to Bull Gore Injury - A Rare Case
Bull horn injuries are common injuries in the rural population 1. These types are injuries are seen in farmers who take care of the cattles. Generally the injuries are seen in the perineal area and lower abdomen 2. I am...
Omphalocele: a Case Report
A neonate with giant omphalocele was posted for repair on 3rd day of life. Anesthesia management was challenging as liver and intestines herniated through the anterior abdominal wall defect. Anticipating post-operative r...
Paradoxical Reaction in a case of Brain Tuberculoma
A 15 year old male was diagnosed to have central nervous system (cns) tuberculosis with ataxia. After starting him on conventional anti tuberculous treatment he deteriorated both clinically and radiologically. On investi...