Association between Serum Vitamin B12 and Folate Levels with Type 2 Diabetes Mellitus On Metformin Therapy

Abstract

Background: Vitamin B12 is a water-soluble vitamin, and its lack causes the methylation process to be disrupted, further resulting in the formation of abnormal fatty acids, which results in neurological manifestations. The water-soluble vitamin folate, often known as folic acid or vitamin B9, is especially vital during high cell division and growth periods. Objective: The study aims to evaluate serum vitamin B12 and folate levels in type 2 diabetic patients with and without metformin therapy and to correlate their levels with other parameters in type 2 diabetes mellitus (T2DM) patients. Subjects and Methods: A cross-sectional controlled study that included 90 participants, 60 type 2 diabetes mellitus patients with metformin therapy designated as (the metformin group) and 30 type 2 diabetes mellitus without metformin therapy considered as (the control group). The study was conducted from December 2021 to the end of March 2021 at private internal medicine clinics in Tikrit City, Iraq. Blood samples were assessed for serum vitamin B12 and folate using Cl-900i Chemiluminescence Immunoassay Analyzer and glycated hemoglobin HbA1c using AFIAS Analyzer in all metformin and control groups. Result: The study showed that there were significant differences in vitamin B12 of (p < 0.01) and folate of (p < 0.05) between the metformin group and the control group. Significant negative correlations were found between vitamin B12 and diabetes mellitus (DM) duration and HbA1c. Folate was negatively correlated and highly significant with DM duration and HbA1c (p < 0.01). Conclusion: The results showed low vitamin B12 and folate levels in T2DM patients. Vitamin B12 and folate were negatively correlated with DM duration and HbA1c. The results suggest a higher risk of vitamin B12 and folate deficiency with metformin use and emphasize the concern of vitamin B12 and folate deficiency in T2DM patients. Keywords: Type 2 Diabetes Mellitus (T2DM); Vitamin B12; Folate; DM duration; HbA1c.