The Prevalence of Vitamin B12 Deficiency in Patients with Type 2 Diabetes: A Cross-Sectional Study

Penelitian ini menunjukkan prevalensi defisiensi vitaminB₁₂ pada pasien diabetes tipe 2, terutama yang mendapatkan metformin. Perlu suplementasi multivitamin untuk mengatasi hal ini. 

 

The Journal of the American Board of Family Medicine September-October 2009 22 (5): 528-534 (2009) © 2009 American Board of Family Medicine
The Prevalence of Vitamin B12 Deficiency in Patients with Type 2 Diabetes: A Cross-Sectional Study. Matthew C. Pflipsen, MD, Robert C. Oh, MD, MPH, Aaron Saguil, MD, MPH, Dean A. Seehusen, MD, MPH, FAAFP and Richard Topolski, PhD.

 

Purpose: The purpose of this study is to define the prevalence of vitamin B₁₂ deficiency in a type 2 diabetic population within a primary care practice. Metformin use and advanced age are associated with vitamin B₁₂ deficiency and often present in type 2 diabetic patients, yet the prevalence of vitamin B₁₂ deficiency in the diabetic population is unknown.

Methods: We conducted a cross-sectional study of 203 outpatient type 2 diabetic patients at a large military primary care clinic. Patients completed a survey and had B₁₂ levels measured. Patients with borderline B₁₂ levels also had methylmalonic acid and homocysteine levels drawn. Serum B₁₂ levels <100 pg/mL or serum B₁₂ levels of 100 to 350 pg/mL with elevation of serum methylmalonic acid >243 nmol/L or homocysteine >11.9 nmol/L defined B₁₂ deficiency. Descriptive statistics described frequency and means. ² and student's t tests were used to analyze associations between categorical and continuous variables, respectively. Multivariate logistical regression identified covariates independently associated with B₁₂ deficiency.

Results: Twenty-two percent (n = 44) of diabetic patients had metabolically confirmed B₁₂ deficiency. Patients on metformin had lower serum B₁₂ levels (425.99 pg/mL vs 527.49 pg/mL; P = .012) and were at increased risk for B₁₂ deficiency (P = .04), as defined by a serum B₁₂ level <350 pg/mL. Prevalence of B₁₂ deficiency was significantly lower for patients using a multivitamin (odds ratio, 0.31; 95% CI, 0.15–0.63).

Conclusions: Our results found a 22% prevalence of metabolically confirmed B₁₂ deficiency in the primary care type 2 diabetic population. Although further research needs to be performed to determine the clinical implications of our findings, B₁₂ deficiency should be considered in type 2 diabetic patients, especially those taking metformin. Furthermore, a daily multivitamin may protect against B₁₂ deficiency.