Prevalence and Characteristics of Vitamin B12 Deficiency Among Patients with Type-2 Diabetes Mellitus in Bahrain- A Cross-Sectional Study

Abstract

Abstract Background: Type-2 Diabetes Mellitus is a chronic metabolic disease characterized by inappropriate hyperglycemia and defects in insulin function. Vitamin B12 is an essential water-soluble vitamin that has a fundamental role in the synthesis of fatty acids, DNA and myelin. Metformin, an oral hypoglycemic agent, was linked to low levels of vitamin B12. This study aimed to determine the prevalence and determinants of vitamin B-12 deficiency among patients with type-2 Diabetes mellitus attending primary healthcare centers in Bahrain. Methods: A cross-sectional study was conducted at five primary healthcare centers in Bahrain. Serum B-12 levels were measured for all patients. Vitamin B-12 levels ≤ 221 pmol/L were considered low, while vitamin B-12 levels of more than 221 pmol/L were considered normal. Results:A total of 691 patients were included in our study with an average age of 58.5±11.2 years. Most participants had hypertension (n=436, 63.1%) and hyperlipidemia (n=367, 53.1%). As high as 92% of the participants were on Metformin and 42.1% (n= 291) were using Insulin formulations. The mean vitamin B-12 level among participants was 278.0 ± 179.3 pmol/L. We found that 40.1% of the patients (n=277) had vitamin B-12 deficiency. Being treated with metformin was the only significant determinant of low vitamin B-12 levels among the cohort (P=0.022). Conclusion: Vitamin B-12 deficiency is prevalent among patients with type-2 diabetes, especially among those on Metformin. Screening for vitamin VB12 deficiency should be considered in diabetic patients especially if treated with Metformin.