High-Risk Metformin Users Not Monitored for Vitamin B12 Deficiency

Article

Patients with type 2 diabetes administered long-term metformin more likely not to have vitamin B12 levels monitored.

Although long-term metformin therapy is associated with lower serum vitamin B12 concentration, high-risk users are often not monitored for vitamin B12 deficiency.

In a study published in the Journal of the American Geriatrics Society, investigators sought to examine the association between long-term metformin therapy and serum vitamin B12 monitoring.

The retrospective cohort study included 3687 veterans 50 years or older with type 2 diabetes and long-term metformin therapy, and 13,258 veterans without diabetes and no prescription for metformin, recruited from a single Veterans Affairs Medical Center (VAMC).

Diabetes status was determined from outpatient visits, and long-term metformin therapy was defined as a prescription ≥500 mg/d for at least 6 consecutive months. The investigators estimated the proportion of participants who received a serum B12 test and used a multivariable logistic regression—–stratified by age­­––to evaluate the association between metformin use and serum B12 testing.

The results of the study showed that of the patients with diabetes receiving metformin, only 37% were tested for vitamin B12 status after long-term metformin prescription.

In the metformin-exposed group, the mean B12 concentration was significantly lower compared with the group without diabetes.

Approximately 7% of study participants administered metformin had a vitamin B12 deficiency compared with 3% of patients without diabetes or metformin use.

Dependent on age, metformin users were 2 to 3 times more likely not to receive vitamin B12 testing compared with those without metformin exposure, according to the study. The findings were the same after adjusting for sex, race/ethnicity, body mass index, and number of years treated at the VAMC.

“Long-term metformin therapy is significantly associated with lower serum vitamin B12 concentrations, yet those at risk are often not monitored for B12 deficiency,” the authors wrote. “Because metformin is first-line therapy for type 2 diabetes, clinical decision support should be considered to promote serum B12 monitoring among long-term metformin users for timely identification of the potential need for B12 replacement.”

Related Videos
Image Credit: Pixel-Shot | stock.adobe.com
Image credit: Wild Awake | stock.adobe.com
Image credit: Dglimages | stock.adobe.com
Home Diabetes Treatment - Image credit: Dglimages | stock.adobe.com
Diabetes patient turn knob on end of insulin pen and dial up correct insulin dose for injection. Scale window on pen syringe showing number of units dose. Medical equipment is easy to self injection - Image credit: Orawan | stock.adobe.com
Patient with diabetes testing blood sugar levels
Bottle and scattered pills on blue backdrop | Image credit: New Africa - stock.adobe.com
© 2024 MJH Life Sciences

All rights reserved.