Abstract
Objectives: To assess the effect of Metformin, this has multiple pharmacodynamic effects and preventionin type 2 diabetes (T2DM).Design: Case - control study.Setting: Outpatient clinics of Diabetic Endocrine Research Lab and patients reporting to medicine departmentof Sheth Vadilal Sarabhai General Hospital ( Smt. NHL Municipal Medical College ) , Ahmedabad, Gujarat .Participants: A total of 240 patients, 100 control group healthy normal and nondiabetic 140 study group withType 2 Diabetes treated with Metformin and not known with a contraindication for the use of Metforminwere approached, given informed consent, and entered the study.e .Intervention : Addition of Metformin to Insulin Therapy three times a day.Primary Outcomes: Vitamin B12, Folic acid , Serum Homocysteine.Results : Metformin Treatment compare with control, was associated with a mean difference in VitaminB12 -340.26 and confidence 6.71 ( 95 % confidence interval 27.53 to 40.95: P= < 0.0001) , and in Folateconcentration of -6.24 and confidence 0.18 ( 95% confidence interval 0.74 to 1.1:P=0.026 ) , and an increasein Homocysteine concentration of 18.97 and confidence 0.93 ( 95% confidence interval 3.83 to 5.69 : P=<0.0001 ) . In addition, decrease Vitamin B12 and Folate could be explained by the increase in Homocysteine.The average person with type 2 DM has 3 times the normal rate of gluconeogenesis, Metformin treatmentreduces this by over one – third.Conclusion : Metformin use for long term has been associated with increased homocysteine level andmalabsorption of Vitamin B12 which is preventable and some researchers and our findings suggests ,recommend screening or prevention strategies .Metformin’s efficacy, security, profile, benefic CardioVascular & metabolic effects, and its capacity to be associated with other antidiabetic agents makes thisdrug the first glucose lowering agent of choice when treating patients with T2DM.
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