PhilSPEN Online Journal of Parenteral and Enteral Nutrition

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(Article 107 | POJ_0101)

Submitted Abstracts

PENSA 2017 Congress

Submitted: August 25, 2017

Abstract ID = 71 | Classification: (4) - Disease specific nutrition issues

Title: Prevalence of peripheral neuropathy among Type 2 DM patients on metformin: is it time for a Vitamin B12 and biguanide combination drug?

Author(s): Naheeda D. Mustofa, MD; Vivian Balsamo, RMT; Mylene Amarante; Regina Najwa Baliguas

Institution where study was conducted: ISCAG Clinic, Dasmarinas Cavite City

Keywords: prevalence, peripheral neuropathy, T2 diabetes mellitus, metformin

Background: Peripheral neuropathy among diabetic patients is already a well-recognized long-term complication. However, highlighting the deficiency of Vitamin B 12 in relation to Metformin use among diabetics has received attention due to its ‘dose-dependent B12-lowering effects’ (Liu Q etal, 2014). Metformin, an oral hypoglycemic agent classified under biguanides used for blood glucose control among patients with Type 2 Diabetes Mellitus, acts by sensitizing insulin receptors. In 2016, a study by Ahmed et al revealed a 28.1% vitamin B12 deficiency prevalence rate among T2DM patients on metformin.

Objectives: To determine the prevalence of peripheral neuropathy among Type 2 DM patients on metformin

Methods: This is a descriptive, cross-sectional study of patients with Type 2 DM on metformin seen at a primary clinic in Cavite between January to June 2017. Presence of peripheral neuropathy as a subjective complaint on consult was documented together with vitamin B supplementation practices.

Results: A total of 38 patients seen were all unaware of the potentially B12-lowering side effect of metformin. Majority were females (65.8%) with an average age of 61 years old. A total of 12 patients (31.5%) presented with peripheral neuropathy, 91% of which had intermittent Vitamin B supplementation while one patient had no vitamin B supplementation for 5 years despite on 1.5gms/day of metformin.

Conclusion: Diabetic neuropathy can be confused with neuropathy from Vit B12 deficiency in metformin-treated diabetics.