Prevalence of vitamin b12 deficiency in type 1 diabetes mellitus and its causes.

Midhun Kumar, B (2015) Prevalence of vitamin b12 deficiency in type 1 diabetes mellitus and its causes. Masters thesis, Madras Medical College, Chennai.

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Abstract

Vitamin B 12 is an essential micro nutrient, required for optimal hemopoietic, neurologic and cardio vascular function. Auto immune destruction of insulin producing beta cells can produce type 1 diabetes and it’s characterized by the presence of insulitis and beta cell auto antibodies. Auto immune gastritis and pernicious anemia are common auto immune diseases present in about 2 % of the population. This prevalence increases to 3 to 5 fold in type 1 diabetes. Presence of parietal cell antibodies and anti-bodies to intrinsic factor has been demonstrated in this population. These factors could contribute to the occurrence of B12 deficiency in these patients. METHODS: In our study about 50 patients with type 1 diabetes mellitus were compared with 50 age and sex matched controls and prevalence of vitamin B12 deficiency was assessed. Presence of anti-intrinsic factor antibody was done in those deficient in vitamin B12. RESULTS: Our study showed that the prevalence of low serum vitamin B12 in type 1 diabetics when compared with age and sex matched controls. 42 % of type 1 diabetes patients had low vitamin B12 level using laboratory cut- off value of 180 pmol/L while only 6 % of controls had low vitamin B12 levels(<180 pmol/l). The presence of anti-intrinsic factor antibodies in those deficient in vitamin B12 was done. Among 24 type 1 diabetes mellitus patients who were deficient in vitamin B12 (<180 pmol/l), 4 patients had anti intrinsic factor antibodies. Among 3 individuals in the control group, who were deficient in vitamin B12 (<180 pmol/l), none of them had anti intrinsic factor antibodies, which was statistically significant which stresses the fact that auto immune pathology for vitamin B12 deficiency. CONCLUSION: Clinical vitamin B12 deficiency is highly prevalent among patients with type 1 DM. These findings merit further research on a larger population using additional markers to investigate into the cause of deficiency, the factors involved, and benefit of B12 supplementation in these patients. Future large and well-designed studies on screening for vitamin B12 deficiency, vitamin B12 supplementation and optimal supplementation dose among type 1 and type 2 diabetic patients are warranted to help guide formulation of guidelines in diabetes clinical care.

Item Type: Thesis (Masters)
Uncontrolled Keywords: Vitamin b12; Type 1 diabetes mellitus
Subjects: MEDICAL > General Medicine
Depositing User: Punitha K
Date Deposited: 07 Aug 2017 09:09
Last Modified: 09 Aug 2017 03:03
URI: http://repository-tnmgrmu.ac.in/id/eprint/2513

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