Sathyarangan, M (2017) Prevalence of Vitamin B12 Deficiency in patients with Type 2 Diabetes Mellitus on Metformin. Masters thesis, Madurai Medical College, Madurai.
|
Text
200100317sathyarangan.pdf Download (2MB) | Preview |
|
|
Text
200100317sathyarangan_abstract.pdf Download (236kB) | Preview |
Abstract
BACKGROUND: Diabetic patients are more prone to develop neuropathy Prolonged vitamin B12 deficiency may result in neuropathy, ranging from paraesthesia and decreased peripheral sensation to altered mental status, subacute combined degeneration of the spinal cord and dementia. Therefore, it is worthwhile to consider the prevalence of vitaminB12 deficiency among the type 2 DM population. AIMS AND OBJECTIVES: Determine the prevalence of vitamin B12 deficiency in patients with T2DM not on metformin and with no history of or treatment for autoimmune diseases. Determine the prevalence of vitamin B12 deficiency in patients with T2DM on metformin and if the presence of vitamin B12 deficiency correlates with dose and duration of metformin therapy. Determine if metformin induced vitamin B12 deficiency is associated with anemia as measured by Hb and MCV or peripheral neuropathy as measured by the absence of sensation to 10g monofilament. This would inform the need for routine annual vitamin B12 measurements in T2DM on metformin. METHODS: Setting: Department of Diabetology & Medicine, Govt. Rajaji Hospital, Madurai Medical College, Madurai. Inclusion criteria: Study Group: Type 2 diabetic on metformin for more than 18 months. Control Group: Type 2 diabetic not on metformin for more than 18 months Exclusion criteria: Parenteral Vitamin B12 supplementation, malabsorption (coeliac disease, inflammatory bowel disease, gastro intestinal surgery) malnutrition (pure veg, anorexia nervosa), chronic alcoholism. DESIGN OF STUDY: Prospective analytical study. PERIOD OF STUDY: 6 Months. PARTICIPANTS: Patients with diabetes mellitus diagnosed according to World Health Organization (WHO) criteria and onset of diabetes after 30 years and duration more than or equal to 5 years, in General Medicine wards or attending Diabetology OPD of Government Rajaji Hospital, Madurai from February 2016 to July 2016. The study will be conducted on 100 patients from General Medicine ward and diabetology OPD of Government Rajaji Hospital, Madurai, in whom serum B12 assay by ELISA method will be done Hundred healthy controls will be selected randomly from bystanders attending the hospital. Significant medical illness will be ruled out by history, physical examination, and investigations. Comparisons among various groups and controls would be made by statistical tests. RESULTS: In those patients taking metformin-Hb value mean was found to be 11.9; And in those taking OHA taking other than metformin, mean Hb found to be 13.58; found to be statistically significant. In those patients taking metformin, neurological deficits seen in 15 persons and other OHA – one person presented with neurological deficit; -statistically significant. In those patients taking metformin for less than 1 year B12 level- 476.154.In those taking metformin for more than 1 year B12 level-338.649Thus found to be statistically significant. Duration and dose of metformin and other OHAs also plays a significant role. Therefore, there is a significant prevalence of Vitamin B12 deficiency in Type 2 diabetic patients on Metformin therapy which showed a positive correlation to the dose & duration of therapy since Diabetic patients are more prone to develop neuropathy, Prolonged vitamin B12 deficiency may result in neuropathy. CONCLUSION : In this study we come to a conclusion that there is a statistical significant prevalence of Vitamin B12 in Type 2 diabetic patients on Metformin therapy which showed a positive correlation to the dose & duration of therapy since Diabetic patients are more prone to develop neuropathy, Prolonged vitamin B12 deficiency may result in neuropathy, ranging from paraesthesia and decreased peripheral sensation to altered mental status, subacute combined degeneration of the spinal cord and dementia, hence Periodic monitoring of serum B12 values in these patients is warrented to avoid serious neurological problems.
| Item Type: | Thesis (Masters) |
|---|---|
| Additional Information: | Reg.No.201411115 |
| Uncontrolled Keywords: | Metformin, Vitamin B12, Peripheral neuropathy. |
| Subjects: | MEDICAL > General Medicine |
| Depositing User: | Subramani R |
| Date Deposited: | 12 Mar 2020 17:21 |
| Last Modified: | 12 Mar 2020 17:21 |
| URI: | http://repository-tnmgrmu.ac.in/id/eprint/12240 |
Actions (login required)
 |
View Item |
