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Factors associated with an increased risk of vitamin B12 deficiency in patients with type 2 diabetes mellitus on metformin.

Background: Metformin is used to treat type 2 diabetes mellitus, but prolonged use has been associated with vitamin B12 deficiency. Many other factors have also been associated with vitamin B12 deficiency. Studies on the possible additive effect of risk factors for developing a vitamin B12 deficienc...

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Published in:Journal of Pharmacy Practice & Research Vol. 54; no. 3; pp. 236 - 242
Main Authors: Wagner, Ross, Mahashabde, Ruchira, Painter, Jacob, Boehmer, Kaci
Format: research tables/charts Journal Article
Published: Wiley-Blackwell Jun2024
Online Access:View this record in EBSCOhost
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      dt: Jun2024
      vid: 54
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      pub: Wiley-Blackwell
      place: Malden, Massachusetts
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        10.1002/jppr.1913
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        atl: Factors associated with an increased risk of vitamin B12 deficiency in patients with type 2 diabetes mellitus on metformin.
      aug:
        au:
          Wagner, Ross
          Mahashabde, Ruchira
          Painter, Jacob
          Boehmer, Kaci
        affil: University of Arkansas for Medical Sciences, Little Rock Arkansas,, USA
      sug:
        subj:
          Diabetes Mellitus, Type 2 Drug Therapy
          Metformin Adverse Effects
          Vitamin B12 Deficiency Risk Factors
          Risk Assessment
          Human
          Male
          Female
          Middle Age
          Aged
          Retrospective Design
          Prospective Studies
          Descriptive Statistics
          Diabetic Patients
          Metformin Therapeutic Use
          Comparative Studies
          Chi Square Test
          T-Tests
          Sex Factors
          Incidence
          Correlational Studies
          Age Factors
          Treatment Duration
          Vitamin B12 Blood
          Vitamin B12 Deficiency Epidemiology
          Arkansas
          Middle Aged: 45-64 years
          Aged: 65+ years
          Male
          Female
      ab: Background: Metformin is used to treat type 2 diabetes mellitus, but prolonged use has been associated with vitamin B12 deficiency. Many other factors have also been associated with vitamin B12 deficiency. Studies on the possible additive effect of risk factors for developing a vitamin B12 deficiency are lacking. Aim: The objective of this study was to assess the correlation between other known risk factors for vitamin B12 deficiency among patients with type 2 diabetes mellitus prescribed metformin who had a vitamin B12 deficiency. Method: For inclusion in this single‐centre, retrospective cohort study, patients needed to be at least 18 years old, diagnosed with type 2 diabetes, taking metformin for at least 2 years and actively taking metformin during the study period. The primary outcome was the rate of low B12 levels with metformin. Secondary outcomes were risk factors associated with B12 deficiency. The patient and clinical characteristics were compared between the two study groups using Student's t‐test for continuous variables and chi‐squared tests for categorical variables. This project was exempt due to the local policy requirements that constitute research by the University of Arkansas for Medical Sciences Institutional Review Board (IRB) (IRB Program Manager, 11 August 2021). The justification for this ethics exemption was as follows: the project was determined to be of minimal risk to privacy of subjects because the research team had mechanisms to protect the personal health identifiers from improper use or disclosure; to destroy the identifiers at the earliest opportunity consistent with the conduct of research, and provided assurance that the identifiers will not be re‐used or disclosed to any other person or entity, except as required by law, for authorised oversight of the research project, or for other research as permitted by the HIPAA regulations. Results: A total of 387 patients were included in this study, from which 364 patients had a vitamin B12 deficiency. The cohort was an average 69‐years‐old and predominantly female (66%). No risk factors were associated with a higher incidence of B12 deficiency. Patient age (p = 0.0063) and time on metformin (p = 0.0144) were significantly and negatively correlated with B12 deficiency. Conclusion: Younger age and shorter duration of metformin use may increase the risk of vitamin B12 deficiency. Although guidelines recommend occasional checks, only 21% of patients had vitamin B12 levels assessed during the study period.
      pubtype: Academic Journal
      doctype:
        research
        tables/charts
        Journal Article
      ougenre: Article
    language: English
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