The Clinical Benefits of the Serum Vitamin B12 Measurement in Japanese Type 2 Diabetes Patients Who are Treated With Metformin

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  • Uenaka Rikako
    Department of Metabolism and Endocrinology, Otemae Hospital
  • Kawata Satoshi
    Department of Metabolism and Endocrinology, Otemae Hospital
  • Nakamura Rei
    Department of Metabolism and Endocrinology, Otemae Hospital
  • Yamada Miki
    Department of Metabolism and Endocrinology, Otemae Hospital
  • Sayama Kouichi
    Department of Metabolism and Endocrinology, Otemae Hospital
  • Uno Sae
    Department of Metabolism and Endocrinology, Otemae Hospital
  • Ito Hidehiko
    Department of Metabolism and Endocrinology, Otemae Hospital

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Other Title
  • メトホルミン服用2型糖尿病患者におけるビタミンB<sub>12</sub>スクリーニングの有用性

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<p>Objective: We performed a cross-sectional observation study to investigate the influence of long-term treatment with biguanide on the reduction of vitamin B12 (Vit B12) levels and prospectively evaluated the clinical benefits of Vit B12 supplementation. Methods: We examined 28 patients with type 2 diabetes mellitus (T2DM) who had taken biguanide over a five-year period; all of the patients had been taking metformin at the time of registration. We also examined 20 T2DM patients who had not been taking biguanide. First their serum Vit B12 concentrations were measured and the patients' tendon reflexes and vibratory sensations were examined. Nine Vit B12 deficient (≤298 pg/mL) patients were prospectively investigated after the administration of mecobalamin (1,500 μg/day) for a six-month period. Results: The average dose of metformin was 950 mg per day (250-1500 mg). The Vit B12 levels did not decrease in the patients who received 250-750 mg of metformin per day. However, they significantly decreased in those taking 1.5 g of metformin per day. Mecobalamin supplementation improved the neurological findings in the six patients out of nine with decreased Vit B12 levels. Conclusions: It is clinically useful to screen the serum Vit B12 levels in Japanese T2DM patients who take metformin at doses of ≥1.5 g per day as it will allow for the timely diagnosis of the onset of neuropathy.</p>

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