Yazidi Meriem, Kammoun Elyes, Oueslati Ibtissem, Chihaoui Melika
Department of Endocrinology, La Rabta Hospital, Faculty of Medicine of Tunis, University of Tunis El Manar, Tunis, Tunisia.
Korean J Fam Med. 2024 Jul;45(4):189-198. doi: 10.4082/kjfm.24.0090. Epub 2024 Jul 18.
Metformin is the most widely used antihyperglycemic drug in patients with type 2 diabetes (T2D). Over the past 2 decades, several studies have highlighted a substantial increase in the risk of vitamin B12 deficiency in patients with T2D on metformin therapy. This can lead to several complications and induce or exacerbate peripheral neuropathy. Despite these data, there are no definite guidelines for screening, diagnosing, and treating vitamin B12 deficiency in patients with T2D on metformin therapy. Therefore, in this narrative review, we aimed to suggest a practical diagnostic and therapeutic strategy to address vitamin B12 deficiency in patients with T2D receiving metformin treatment. Clinical evidence supporting an increased risk of vitamin B12 deficiency in patients with T2D on metformin therapy and its risk factors and potential complications are also discussed.
二甲双胍是2型糖尿病（T2D）患者中使用最广泛的抗高血糖药物。在过去20年中，多项研究强调了接受二甲双胍治疗的T2D患者维生素B12缺乏风险大幅增加。这可能导致多种并发症，并诱发或加重周围神经病变。尽管有这些数据，但对于接受二甲双胍治疗的T2D患者维生素B12缺乏的筛查、诊断和治疗，尚无明确的指南。因此，在本叙述性综述中，我们旨在提出一种实用的诊断和治疗策略，以解决接受二甲双胍治疗的T2D患者的维生素B12缺乏问题。还讨论了支持接受二甲双胍治疗的T2D患者维生素B12缺乏风险增加及其危险因素和潜在并发症的临床证据。
