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Diabetes Res Clin Pract. 2012 Sep;97(3):359-67. doi: 10.1016/j.diabres.2012.06.001. Epub 2012 Jul 7.

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

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1
Department of Internal Medicine, Naval Hospital of Crete, 73 200 Chania, Crete, Greece. emazokopakis@yahoo.gr

Abstract

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.

PMID:
22770998
DOI:
10.1016/j.diabres.2012.06.001
[Indexed for MEDLINE]
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