Recommendations for diagnosis and management of

Diabetes Res. Clin. Pract. · Sep 2012

Review

Recommendations for diagnosis and management of metformin-induced vitamin B12 (Cbl) deficiency.

Metformin treatment is a known pharmacological cause of vitamin B12 (Cbl) deficiency with controversial responsible mechanisms. A possible diagnosis of this deficiency is based mainly on the combination of patient's medical history (usually long-term metformin use), clinical examination (possible neuropsychiatric symptoms and signs), laboratory studies which confirm a Cbl deficiency (haematological abnormalities, low serum Cbl levels, elevated serum total homocysteine and methylmalonic acid levels), and exclusion other causes of Cbl deficiency (as pernicious anaemia, food-cobalamin malabsorption syndrome, other drugs, etc.). In our review, recommendations for diagnosis and management of metformin-induced Cbl deficiency (MICD) in diabetic patients based on medical bibliography are presented and discussed.

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- Elias E Mazokopakis and Ioannis K Starakis.
- Department of Internal Medicine, Naval Hospital of Crete, 73 200 Chania, Crete, Greece. emazokopakis@yahoo.gr
- Diabetes Res. Clin. Pract. 2012 Sep 1; 97 (3): 359-67.
AbstractMetformin treatment is a known pharmacological cause of vitamin B12 (Cbl) deficiency with controversial responsible mechanisms. A possible diagnosis of this deficiency is based mainly on the combination of patient's medical history (usually long-term metformin use), clinical examination (possible neuropsychiatric symptoms and signs), laboratory studies which confirm a Cbl deficiency (haematological abnormalities, low serum Cbl levels, elevated serum total homocysteine and methylmalonic acid levels), and exclusion other causes of Cbl deficiency (as pernicious anaemia, food-cobalamin malabsorption syndrome, other drugs, etc.). In our review, recommendations for diagnosis and management of metformin-induced Cbl deficiency (MICD) in diabetic patients based on medical bibliography are presented and discussed.Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

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Recommendations for diagnosis and management of metformin-induced vitamin B12 (Cbl) deficiency.

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