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Review
. 2024 Sep 3;16(9):e68550.
doi: 10.7759/cureus.68550. eCollection 2024 Sep.

Vitamin B12 Deficiency in Patients Taking Metformin: Pathogenesis and Recommendations

Noor Ul Huda Ramzan  1 , Khadija Shahjahan  2 , Rubaid A Dhillon  3 , Nimra Tul Ain Khan  4 , Muhammad Bilal Hashmat  5 , Mian Uman Anwer  5 , Dawood Ahmed  2 , Fazila Afzal  2 , Muhammad Mashhood Tahir  5 , Ayesha Muzaffar  6
Affiliations
Review

Vitamin B12 Deficiency in Patients Taking Metformin: Pathogenesis and Recommendations

Noor Ul Huda Ramzan et al. Cureus. .

Abstract

Metformin is a cornerstone therapy for type 2 diabetes mellitus due to its glucose-lowering efficacy and additional benefits such as reducing cardiovascular mortality. However, accumulating evidence suggests an association between long-term metformin use and vitamin B12 deficiency, which can lead to serious clinical consequences. This review aims to synthesize current knowledge on the pathogenesis, prevalence, clinical implications, and management of metformin-induced vitamin B12 deficiency. Given the significant clinical implications, it is crucial to monitor and manage vitamin B12 levels in patients using metformin. This review emphasizes the importance of early detection and supplementation to prevent adverse outcomes. By analyzing the current evidence, the review aims to inform healthcare professionals about best practices for managing vitamin B12 deficiency in patients on metformin, offering insights to guide future clinical practices and research directions.

Keywords: diabetes mellitus; metformin side effects; neurological outcomes; screening; supplementation; vitamin b12 deficiency; vitamin b12 deficiency anemia.

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Conflict of interest statement

Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work.

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