Khalaf Kareem Mousa, Khudhair Mahmod Shakir, Ashor Ammar Waham
Department of Internal Medicine, Al-Sadar Medical City, Al-Najaf.
Department of Internal Medicine, College of Medicine, Al-Nahrain University, Baghdad,Iraq.
J Pak Med Assoc. 2019 Aug;69(Suppl 3)(8):S40-S44.
To assess the status of vitamin B12 in patients with type 2 diabetes, and to explore any association between its deficiency and diabetic peripheral neuropathy.
This cross-sectional observational study was conducted from August, 2017, to April, 2018, at the Specialized Centre for Endocrinology and Diabetes in Baghdad, Iraq. Type 2 diabetics using metformin were subjected to clinical examination for retinopathy using fundoscopy, and peripheral neuropathy using the Michigan Neuropathy Screening Instrument. Additionally, patients were asked to fill a questionnaire and their medical records were reviewed. Blood samples were obtained for the measurement of biomarkers. Vitamin B12 deficiency was recorded at ≤187 pg/ml. Data was analysed using SPSS 25.
Of the 66 patients, 39(59%) were males and 27(41%) were females. The overall mean age was 53.3}9.2 years and the mean duration of diabetes was 104}71.8 months. The mean dose of metformin was 1135}496 mg and the duration of metformin use was 72}62 months. Overall, 19(29%) patients suffered from vitamin B12 deficiency. However, no significant difference was found between normal and deficit groups regarding the parameters that may affect vitamin B12 level. Also, no significant correlations were found between vitamin B12 concentration and the dose (p=0.16) or the duration of metformin use (p=0.09).
High prevalence of vitamin B12 deficiency was observed in metformin-treated patients with type 2 diabetes. However, the deficiency had no correlation with the rate of peripheral neuropathy.
评估2型糖尿病患者维生素B12的状况，并探讨其缺乏与糖尿病周围神经病变之间的关联。
本横断面观察性研究于2017年8月至2018年4月在伊拉克巴格达的内分泌与糖尿病专科医院进行。使用二甲双胍的2型糖尿病患者接受眼底镜检查以评估视网膜病变，并使用密歇根神经病变筛查工具评估周围神经病变。此外，要求患者填写问卷并查阅其病历。采集血样以测量生物标志物。维生素B12缺乏定义为≤187 pg/ml。使用SPSS 25进行数据分析。
66例患者中，男性39例（59%），女性27例（41%）。总体平均年龄为53.3±9.2岁，糖尿病平均病程为104±71.8个月。二甲双胍的平均剂量为1135±496 mg，使用二甲双胍的时间为72±62个月。总体而言，19例（29%）患者存在维生素B12缺乏。然而，在可能影响维生素B12水平的参数方面，正常组和缺乏组之间未发现显著差异。此外，维生素B12浓度与二甲双胍剂量（p=0.16）或使用时间（p=0.09）之间均未发现显著相关性。
在使用二甲双胍治疗的2型糖尿病患者中观察到维生素B12缺乏的高患病率。然而，这种缺乏与周围神经病变的发生率无关。
