Abstract
Metformin is one of the most commonly used oral hypoglycemic drug amongst type II diabetes mellitus patients, particularly overweight with normal kidney functions. Literature reports an average of 10-30% of patients taking metformin for longer duration (more than 4 years) have shown some signs of vitamin B12 deficiency.
 Thus the present study was planned to assess the development of peripheral neuropathy in metformin users due to Vitamin B12 deficiency and effect of its supplementation was assessed for improvement in terms of VPT (Vibration perception threshold) score assessed by Biothesiometer which is a simple, portable, reliable, non-invasive method to screen the peripheral neuropath
 Unique about this study is, evaluating the effect of B12 supplementation on Indians patients. They being primarily vegetarian are at more risk to develop Vitamin B12 deficiency, so, metformin induced Cobalamin deficiency assumes greater risk in such patients in terms of development and progression of peripheral neuropathy.
Highlights
Recent data from International Diabetes Federation shows that 463 million adults are currently living with diabetes
The table shows that more the dose and duration of metformin use, more are the VPT scores which might mean that there are more chances of development of peripheral neuropathy in such patients and the results were in line with the data already available in the medical literature
We demonstrated that metformin dosage and treatment duration could be consistent risk factors for development of vitamin B12 deficiency in type 2 Diabetes patients
Summary
Recent data from International Diabetes Federation shows that 463 million adults are currently living with diabetes. Diabetes is one of the fastest growing health challenges of the 21st century, with the number of adults living with diabetes having more than tripled over the past 20 years. The worldwide prevalence of Diabetes Mellitus has risen dramatically over the past two decades, from an estimated 30 million cases in 1985 to 382 million in 2013 of these more than 90% are type 2 DM1 metformin - lactic acidosis, is very rare and can be prevented by careful patient selection. Malabsorption of vitamin B12 in diabetic patients treated with metformin was first noted in 1969. Subsequent studies revealed a prevalence of vitamin B12 deficiency in the range of 10 to 30% of diabetic patients using metformin. The mechanisms are thought to be related to slowing of the bowel transit time resulting in bacterial overgrowth and interference of the Biguanide with the absorption of vitamin B12 5
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