Hussain Md Sadique, Srivastava Nitya, Singh Gurvinder, Kumar Rajesh
School of Pharmaceutical Sciences, Jaipur National University, Jaipur, Rajasthan, India.
School of Pharmaceutical Sciences, Lovely Professional University, Phagwara, Punjab, India.
Curr Drug Saf. 2025;20(3):258-270. doi: 10.2174/0115748863308106240816044733.
This extensive review delves into the complex relationship between prolonged use of metformin and the possible emergence of vitamin B12 deficiency (VB12D) in diabetic patients. Metformin, a pivotal element in diabetes management, is constantly linked with decreased absorption of vitamin B12, prompting concerns about the enduring consequences of this interaction. The review systematically amalgamates current evidence, elucidating the prevalence, mechanisms, and clinical ramifications of VB12D induced by consistent consumption of metformin. Exploring the different pathways through which metformin might disrupt the absorption of Vitamin B12, the review encompasses interference with the calcium-dependent membrane activity and alterations of the microbiota present in the gut. A meticulous analysis of experimental studies and human trials is undertaken, accentuating the prevalence of variable VB12D among individuals on long-duration treatment of metformin across diverse populations and age groups. Clinical indications of cobalamin deficiency, spanning haematological abnormalities to neurological complications, are systematically examined. Furthermore, the review delves into the potential implications of cobalamin deficiency associated with metformin on diabetes-related complications and overall patient health. This review offers a comprehensive overview of the intricate interplay between the use of metformin and deficiency of vitamin B12 in diabetic patients, emphasizing the importance that lies in routine monitoring, early detection, and personalized interventions to optimize the long-period safety and efficiency of metformin in the treatment of diabetes. It also proposes future research directions to refine clinical guidelines and enhance the understanding regarding the correlation between diabetes, metformin, and vitamin B12.
这篇全面的综述深入探讨了糖尿病患者长期使用二甲双胍与可能出现维生素B12缺乏症（VB12D）之间的复杂关系。二甲双胍作为糖尿病管理中的关键要素，一直与维生素B12吸收减少有关，这引发了人们对这种相互作用的长期后果的担忧。该综述系统地整合了当前证据，阐明了持续服用二甲双胍所致VB12D的患病率、机制及临床影响。通过探索二甲双胍可能干扰维生素B12吸收的不同途径，该综述涵盖了对钙依赖性膜活性的干扰以及肠道内微生物群的改变。对实验研究和人体试验进行了细致分析，强调了在不同人群和年龄组中接受长期二甲双胍治疗的个体中VB12D的患病率差异。系统地检查了钴胺素缺乏的临床指征，从血液学异常到神经并发症。此外，该综述还深入探讨了与二甲双胍相关的钴胺素缺乏对糖尿病相关并发症和患者整体健康的潜在影响。这篇综述全面概述了糖尿病患者使用二甲双胍与维生素B12缺乏之间的复杂相互作用，强调了常规监测、早期检测和个性化干预对于优化二甲双胍治疗糖尿病的长期安全性和有效性的重要性。它还提出了未来的研究方向，以完善临床指南并加深对糖尿病、二甲双胍和维生素B12之间相关性的理解。
