Metformin is the first line agent for type 2 diabetic patients. It is also one of the few antihyperglycaemic agents that are associated with improvements in cardiovascular morbidity and mortality.
However, a study recently published in the May 20 issue of the BMJ, indicated that long-term metformin treatment is linked to vitamin B12 deficiency.
At the outpatient clinics of 3 nonacademic hospitals in the Netherlands, 390 patients with type 2 diabetes being treated with insulin received 850 mg of metformin or placebo 3 times daily for 4.3 years.
At the end of the study, patients in the metformin group experienced a 19% reduction in vitamin B12 concentration, (95% confidence interval [CI], −24% to −14%; P < .001), a 5% reduction in folate (95% CI, −10% to −0.4%; P = .033), and 5% increase in homocysteine (95% CI, −1% to 11%; P = .091).
If you have been taking or will take metformin for a long time, remember to ask your doctor to check your vitamin B-12 level regularly.
Deficiency of vitamin B12 is associated with anemia and central nervous system damage. Signs and symptoms associated with vitamin B12 deficiency include tiredness, a decreased mental work capacity, weakened concentration and memory, irritability and depression.
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Source: online May 2010 BMJ.