Vitamin B12 deficiency and peripheral neuropathy
Systematic monitoring of vitamin B12 levels can prevent irreversible nerve damage to type 2 diabetes
Patients with type-2 diabetes, taking metformin, should have their vitamin B12 levels assessed more regularly to avoid irreversible nerve damage, according to a new study presented at the Society for Endocrinology annual conference in Glasgow.
The study findings suggest that earlier detection of vitamin B12 deficiency through routine screening of all metformin-treated, type-2 diabetes patients could reduce their risk of developing irreversible, painful and potentially disabling nerve damage.
The increasing incidence of type-2 diabetes is a serious health issue worldwide.
Its prevalence is associated with poor diet and unhealthy lifestyle choices, and it is characterized by high blood glucose levels that need to be controlled by medication.
Nerve damage in the periphery (e.g. face, limbs, organs) is a common complication of diabetes, with symptoms that range from numbness to pain, and can lead to debilitating loss of balance and coordination.
Metformin is the recommended and most effective first-line drug for type-2 diabetes, but its use has also been linked to vitamin B12 deficiency, which increases the risk of peripheral nerve damage. Despite the irreversibility of peripheral nerve damage, no official guidelines exist on screening vitamin B12 levels in patients treated with metformin.
In this study,
The audit findings indicated that 64% of patients had not had their vitamin B12 levels checked at all and that 9.6% of patients were deficient but only 6.4% were being treated with vitamin B12.
However, she also cautions, "Metformin remains the best treatment for type-2 diabetes, these findings should not discourage patients from taking it, but encourage doctors to monitor vitamin B12 levels more routinely, so any deficiency can quickly be treated."