Vitamin B 12 DeficiencyMetforminHypoglycemic AgentsMiddle AgedMaleBackgroundMetformin is one of the most commonly used medications for the treatment of type 2 diabetes mellitus. Potential side effects of metformin include diarrhea, lactic acidosis, and, less commonly reported, vitamin B12 deficiency. We...
Long term treatment with metformin in patients with type 2 diabetes and risk of vitamin B-12 deficiency: randomised placebo controlled trial ObjectivesTo study the effects of metformin on the incidence of vitamin B-12 deficiency (<150 pmol/l), low concentrations of vitamin B-12 (150-220 pmol...
Renal: Obtain eGFR at baseline and repeat at least annually; assess renal function more often in patients at risk for developing renal impairment (e.g., elderly) Hematologic: Measure hematologic parameters annually; periodically asses Vitamin B-12 levels, especially in patients with peripheral neuropa...
• Vitamin B 12 Deficiency: Metformin may lower vitamin B 12 levels. Measure hematological parameters annually and vitamin B 12 at 2 to 3 year intervals and manage any abnormalities. (5.2) (5) • Hypoglycemia with Concomitant Use with Insulin and Insulin Secretagogues: Increased risk of hyp...
Frequent gastrointestinal side effects in the form of diarrhea, nausea, bloating and flatulence, cramping and abdominal pain. Prolonged use may cause malabsorption of vitamin B1234. Lactic acidosis (a build-up of lactic acid in the blood) is the feared adverse effect of the biguanide drugs. Howe...
Study of Vitamin B 12 deficiency and peripheral neuropathy in metformin-treated early Type 2 diabetes mellitus Long-term therapy with metformin was shown to decrease the Vitamin B12level and manifested as peripheral neuropathy. The aim of this study is to define the... RP Roy,K Ghosh,M Ghosh...
Gastro-intestinal symptoms may disappear with time, and usually remit rapidly with a reduction in dosage or stopping treatment. During chronic therapy there may be reduced absorption of vitamin B12 and folate. Ovulation can occur in anovulatory polycystic ovarian syndrome. There is risk of lactic ...
de Jager J, Kooy A, Lehert P, Wulffele MG, van der Kolk J, Bets D, Verburg J, Donker AJ, Stehouwer CD: Long term treatment with metformin in patients with type 2 diabetes and risk of vitamin B-12 deficiency: randomised placebo controlled trial. BMJ. 2010, 340: c2181-10.1136/bmj....
Monitor hematologic parameters annually and vitamin B12 at 2 to 3 year intervals and manage any abnormalities. (5.2) Hypoglycemia with Concomitant Use with Insulin and Insulin Secretagogues: Increased risk of hypoglycemia when used in combination with insulin and/or an insulin secretagogue. Lower ...
Decreased serum vitamin B12 concentrations, with or without clinical manifestations (e.g., anemia).Symptoms rapidly reversible following discontinuation of metformin or supplementation with vitamin B12. Monitor hematologic parameters (e.g., hemoglobin, serum vitamin B12 concentrations) prior to initiation ...