International Journal of Contemporary Medicine
  • Year: 2015
  • Volume: 3
  • Issue: 2

Studies on Homocysteine, Vitamin B12 & Folic Acid Status on Patients with Type 2 Diabetes Mellitus Being Treated with Metformin

1Assistant Professor, Department of Biochemistry, AMC MET Medical College, Maninagar, Ahmedabad, Gujarat

2Associate Professor, Department of Anatomy, AMC MET Medical College, Maninagar, Ahmedabad, Gujarat

3Associate Professor, Department of Forensic Medicine, AMC MET Medical College, Maninagar, Ahmedabad, Gujarat

4Professor & HOD, Department of Biochemistry, Pramukh Swami Medical College, Karamsad, Anand, Gujarat

Abstract

To study the effects of Metformin in adult with Type 2 Diabetes on the incidence of vitamin B12 deficiency and Folate and increase levels of Homocysteine concentrations, a cardiovascular risk factor.

Case - control study.

Outpatient clinics of Diabetic Endrocrine Research Lab and patients reporting to medicine department of Sheth Vadilal Sarabhai General Hospital (Smt. NHL Municipal Medical College), Ahmedabad, Gujarat.

A total of 240 patients,100 control group healthy normal and nondiabetic, 140 study group with Type 2 Diabetes treated with Metformin and not known with a contraindication for the use of Metformin were approached, given informed consent, and entered the study.

Addition of Metformin to Insulin Therapy three times a day.

Serum Homocysteine, Folate, Vitamin B12 and body weight.

Compare with control, Metformin Treatment was associated with a mean difference in Vitamin B12 -340.26 and confidence 6.71 (95% confidence interval 27.53 to 40.95: P= < 0.0001), and in Folate concentration of - 6.24 and confidence 0.18 (95% confidence interval 0.74 to 1.1: P=0.026), and an increase in Homocysteine concentration of 18.97 and confidence 0.93 (95% confidence interval 3.83 to 5.69: P= < 0.0001). In addition, the increase in Homocysteine could be explained by decrease in Folate and Vitamin B12.

In patient with Type 2 Diabetes long term treatment with Metformin increases the risk of B12 deficiency and Folate, which results in a modest increase in Homocysteine concentration. Vitamin B12 Deficiency is preventable, therefore our findings suggests that regular measurements of Vitamin B12 and folate concentrations during long term Metformin treatment should be strongly considered.

Keywords

Diabetes, Homocysteine, Insulin, Metformin, Vitamin B12 and Folate