Routine screening for vitamin B12 deficiency in all patients with type 2 diabetes treated with metformin could prevent irreversible nerve damage (neuropathy).
Patients with type 2 diabetes who take metformin should have their vitamin B12 levels tested more regularly to avoid irreversible nerve damage, new research suggests. Routine screening for vitamin B12 deficiency of all patients with type 2 diabetes treated with metformin may reduce this risk.
Irreversible, nerve damage is a common complication of diabetes, with symptoms ranging from numbness to pain and can lead to debilitating loss of balance and coordination. They can affect the face, limbs or organs of patients.
No official guidelines
Metformin is the recommended first-line medication for type 2 diabetes, but its use has also been linked to vitamin B12 deficiency. There are currently no official guidelines for screening vitamin B12 levels in patients treated with metformin.
In this study, Dr. Kaenat Mulla and colleagues audited screening and vitamin B12 deficiency in women with type 2 diabetes treated with metformin. Result: 64% of patients had not had their vitamin B12 levels checked, 9.6% had a deficiency, and only 6.4% consumed it in the form of treatment.
Annual Review
“Current guidelines from the British Society of Haematology recommend that vitamin B12 levels should only be checked when there is clinical suspicion of a deficiency. However, peripheral neuropathy is irreversible and it may be too late once symptoms develop” , laments Dr. Kaenat Mulla. The researchers now plan to continue their audit to determine how best to treat patients with vitamin B12 deficiency. For them, all patients with type 2 diabetes on metformin should have their levels checked more regularly, for example during their annual check-up.
In France, in 2015, 3.7 million people were taking medication for their diabetes (i.e. 5.4% of the population). Added to this are diabetics who ignore themselves. This prevalence* continues to increase, particularly among men, young people and the oldest.
*Source: Federation of diabetics.
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