Özet:

Vitamin B12 deficiency is a side effect of metformin use in patientswith type 2 diabetes mellitus (T2DM) and associated with increase in plasma homocysteine levels.The aim of present work was to screen vitamin B12 and homocysteine levels in patients with T2DM on metformin therapy. Patients with T2DM collected from Fayoum University hospital outpatient clinics were screened and divided into three groups. Group 1 was thirty patients on metformin therapy for more than one year without vitamin B12 supplementation; group 2 was thirty patients on metformin therapy for more than one year on vitamin B12 supplementation and group 3 was patients not receiving metformin therapy (control group). All patients were subjected to complete history taking, including peripheral neuropathy and laboratory investigations. The mean±SD serum vitamin B12 level was significantly higher in the metformin and vitamin B12 supplementation users compared to metforminonly and nonmetformin users (p < 0.001), 629.9±249, 216±109 and 354.6±177.6 ng/L, respectively. Homocysteine levels were similar in the three groups. There was a significant correlation between metformin dose and vitamin B12 levels (P < 0.05), also between vitamin B12 deficiency and hyperhomocysteinemia (P < 0.01, r=-0.45). There was significant relation between homocysteine and macrovascular complications (r= 0.33, P < 0.01) and between vitamin B12and peripheral neuropathy (P < 0.01, r=-0.303). Vitamin B12 deficiency was found to be associated with metformin use in T2DM patients with significant correlation with diabetic peripheral neuropathy and hyper-homocysteinemia, whereas vitamin B12 supplementation with metformin could prevent those effects

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