Volume : 7, Issue : 11, November - 2018

Estimation of vitamin B12 levels in patients with type 2 diabetes mellitus on metformin: A Hospital Based Study

Dr Prafulla Kumar Mishra, Dr Brijesh Mukherjee

Abstract :

<p>&nbsp;</p> <p class="MsoNormal" style="text-align:justify;text-justify:inter-ideograph"><b style="mso-bidi-font-weight:normal"><span lang="EN-IN" style="font-size:12.0pt;&#10;line-height:115%;font-family:&quot;Agency FB&quot;,&quot;sans-serif&quot;;mso-bidi-font-family:&#10;&quot;Times New Roman&quot;">Background: </span></b><span lang="EN-IN" style="font-size:&#10;12.0pt;line-height:115%;font-family:&quot;Agency FB&quot;,&quot;sans-serif&quot;;mso-fareast-font-family:&#10;MinionPro-Regular;mso-bidi-font-family:&quot;Times New Roman&quot;">Metformin is considered as the first-line antidiabetic agent in the treatment of type 2 diabetes mellitus (T2DM) due to its effect on glucose and lipid metabolism. </span><span lang="EN-IN" style="font-size:12.0pt;line-height:115%;font-family:&quot;Agency FB&quot;,&quot;sans-serif&quot;;&#10;mso-bidi-font-family:&quot;Times New Roman&quot;;color:black">The mechanism of action of Metformin in improving hyperglycemia involves in improving the signaling of insulin together with suppressing hepatic gluconeogenesis. </span><b style="mso-bidi-font-weight:normal"><span lang="EN-IN" style="font-size:12.0pt;&#10;line-height:115%;font-family:&quot;Agency FB&quot;,&quot;sans-serif&quot;;mso-bidi-font-family:&#10;&quot;Times New Roman&quot;">Methods: </span></b><span lang="EN-IN" style="font-size:12.0pt;&#10;line-height:115%;font-family:&quot;Agency FB&quot;,&quot;sans-serif&quot;;mso-bidi-font-family:&#10;&quot;Times New Roman&quot;">45 patients with type-2 diabetic patients <span style="color:black">on metformin therapy </span><span style="mso-spacerun:yes">&nbsp;</span>with an age ranged from 30 to 65 years along with 45 healthy controls were recruited from the<span style="mso-spacerun:yes">&nbsp; </span>General Medicine Department of HMCH, Rourkela according to inclusion and exclusion criteria. <b style="mso-bidi-font-weight:&#10;normal">Results: </b></span><span lang="EN-IN" style="font-size:12.0pt;&#10;line-height:115%;font-family:&quot;Agency FB&quot;,&quot;sans-serif&quot;;mso-bidi-font-family:&#10;ArialMT">The mean age and BMI of both the cases and controls were </span><span lang="EN-IN" style="font-size:12.0pt;line-height:115%;font-family:&quot;Agency FB&quot;,&quot;sans-serif&quot;;&#10;mso-bidi-font-family:Garamond">48.62 &plusmn; 7.94 </span><span lang="EN-IN" style="font-size:12.0pt;line-height:115%;font-family:&quot;Agency FB&quot;,&quot;sans-serif&quot;;&#10;mso-bidi-font-family:ArialMT">and </span><span lang="EN-IN" style="font-size:&#10;12.0pt;line-height:115%;font-family:&quot;Agency FB&quot;,&quot;sans-serif&quot;;mso-bidi-font-family:&#10;Garamond">43.52 &plusmn; 5.24; </span><span lang="EN-IN" style="font-size:12.0pt;&#10;line-height:115%;font-family:&quot;Agency FB&quot;,&quot;sans-serif&quot;;mso-bidi-font-family:&#10;&quot;Times New Roman&quot;">28.04 &plusmn; 4.34 and 26.54 &plusmn; 3.32 </span><span lang="EN-IN" style="font-size:12.0pt;line-height:115%;font-family:&quot;Agency FB&quot;,&quot;sans-serif&quot;;&#10;mso-bidi-font-family:ArialMT">respectively. </span><span lang="EN-IN" style="font-size:12.0pt;line-height:115%;font-family:&quot;Agency FB&quot;,&quot;sans-serif&quot;;&#10;mso-bidi-font-family:&quot;Times New Roman&quot;">Mean serum vitamin B12 levels in the case group was <span style="color:black">217.45&plusmn;86.32 </span>and in control was <span style="color:black">370.08&plusmn;91.6</span>and the difference was statistically significant. <b style="mso-bidi-font-weight:normal">Conclusion: </b>Metformin which is first line oral hypoglycemic agent as recommended by ADA is significantly associated with decrease in vitamin B12. </span><span lang="EN-IN" style="font-size:12.0pt;line-height:115%;font-family:&quot;Agency FB&quot;,&quot;sans-serif&quot;;&#10;mso-bidi-font-family:Garamond;color:black">There is moderate correlation between the markers of B12 status and levels of fasting blood sugar as well as HbA1C. There is a significant correlation between insulin and C-peptide with the markers of vitamin B12 status.</span><b style="mso-bidi-font-weight:normal"><span lang="EN-IN" style="font-size:12.0pt;line-height:115%;font-family:&quot;Agency FB&quot;,&quot;sans-serif&quot;;&#10;mso-bidi-font-family:&quot;Times New Roman&quot;"><o:p></o:p></span></b></p>