PDF(Pubmed)
Abstract：
Background Long-term metformin treatment in individuals with type 2 diabetes mellitus causes vitamin B12 insufficiency, which is typically neglected, undetected, and under-treated. A severe deficit may cause life-threatening neurological problems. This study assessed the prevalence of vitamin B12 deficiencies among T2DM patients and its factors at a tertiary hospital in the Tamil Nadu district of Salem. Materials and Methods This is an analytical cross-sectional study conducted in a tertiary care hospital in the Salem district, Tamil Nadu, India. Patients with type 2 diabetes mellitus who were prescribed metformin at the outpatient department of general medicine took part in the trial. Our research instrument was a structured questionnaire. We used a questionnaire containing information on sociodemographic characteristics, metformin use among diabetic mellitus patients, diabetes mellitus history, lifestyle behaviors, anthropometric measurement, examination findings, and biochemical markers. Prior to administering the interview schedule, each participant\'s parents provided written informed consent. A thorough medical history, physical exam, and anthropometric examination were performed. Data were entered in Microsoft Excel (Microsoft Corporation, Redmond, WA) and analyzed using SPSS version 23 (IBM Corp., Armonk, NY). Results Among the study participants, we diagnosed nearly 43% of diabetes cases in participants between the ages of 40-50 years, while we diagnosed 39% aged under 40 years. Nearly 51% had diabetes for 5-10 years, while only 14% had diabetes for over 10 years. In addition, 25% of the study sample had a positive family history of type 2 diabetes. Nearly 48% and 13% of the study group had been on metformin for 5-10 years and >10 years, respectively. The majority, 45%, were found to take 1000 mg of metformin per day, whereas just 15% take 2 g per day. In our study, the prevalence of vitamin B12 insufficiency was 27%, and nearly 18% had borderline levels. The duration of diabetes mellitus, the duration of metformin intake, and the dose of metformin were statistically significant (p-value = 0.05) among the variables associated with diabetes mellitus and vitamin B12 deficiency. Conclusion The results of the study show that a deficiency in vitamin B12 increases the likelihood that diabetic neuropathy would worsen. Therefore, individuals with diabetes who take larger dosages of metformin (more than 1000mg) for an extended period must have their vitamin B12 levels monitored often. Preventative or therapeutic vitamin B12 supplementation can mitigate this issue.
摘要：
背景长期二甲双胍治疗2型糖尿病患者会导致维生素B12不足，通常被忽略，未被发现,和治疗不足。严重的缺陷可能会导致危及生命的神经系统问题。这项研究评估了塞勒姆泰米尔纳德邦地区一家三级医院的T2DM患者中维生素B12缺乏的患病率及其影响因素。材料和方法这是在塞勒姆区的三级保健医院进行的分析性横断面研究，泰米尔纳德邦,印度。在普通内科门诊服用二甲双胍的2型糖尿病患者参加了试验。我们的研究工具是结构化问卷。我们使用了一份包含社会人口统计学特征信息的问卷，糖尿病患者使用二甲双胍，糖尿病史,生活方式行为，人体测量,检查结果，和生化标记。在管理面试时间表之前，每位参与者的父母均提供了书面知情同意书.彻底的病史，体检,并进行人体测量学检查。数据在微软Excel中输入(微软公司，雷德蒙德,WA)，并使用SPSS版本23(IBMCorp.,Armonk,NY).结果在研究参与者中，我们在40-50岁的参与者中诊断出将近43％的糖尿病病例，而我们诊断出39%的年龄在40岁以下。近51%的人患有糖尿病5-10年，而只有14%的人患有糖尿病超过10年。此外,25%的研究样本有2型糖尿病家族史。研究组中有近48％和13％的人服用二甲双胍5-10年和>10年。分别。大多数,45%,被发现每天服用1000毫克二甲双胍，而只有15%的人每天服用2克。在我们的研究中,维生素B12不足的患病率为27%，近18%的人有临界水平。糖尿病的持续时间，二甲双胍摄入的持续时间，在与糖尿病和维生素B12缺乏相关的变量中，二甲双胍的剂量具有统计学意义（p值=0.05）。结论研究结果表明，维生素B12的缺乏增加了糖尿病神经病变恶化的可能性。因此,长期服用更大剂量二甲双胍（超过1000mg）的糖尿病患者必须经常监测其维生素B12水平。预防性或治疗性维生素B12补充剂可以缓解这个问题。
