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Year : 2022  |  Volume : 14  |  Issue : 2  |  Page : 89-93

Decreased serum B12 due to antidiabetic drugs: Is it a potential contributor to inflammation in Type II diabetes mellitus

1 Department of Physiology, Apollo Institute of Medical Sciences and Research, Hyderabad, Telangana, India
2 Professor of Medicine, Saveetha Medical College Hospital, Chennai, Tamil Nadu, India

Correspondence Address:
Divya Kanchi
Apollo Institute of Medical Sciences and Research, Hyderabad, Telangana
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/ajprhc.ajprhc_30_22

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Background: The first-line medication, metformin, can decrease hepatic gluconeogenesis and improve insulin sensitivity. Metformin inhibits the mitochondrial respiratory chain at the molecular level, which leads to an increase in adenosine monophosphate-activated protein kinase, which enhances insulin sensitivity. With no known renal or hepatic disease, updated recommendations recommend using metformin as a first-line glucose-lowering medication in conjunction with lifestyle changes. Metformin has been demonstrated to lower vitamin B12 levels. Vitamin B12 is a vitamin that is necessary for proper hemopoietic, neurocognitive, and cardiovascular function. Vitamin B12 deficiency has been shown to be quite common in people with type 2 diabetes mellitus, both biochemically and clinically. Diabetes is thought to be an oxidative stress and chronic inflammatory disease. Vitamin B-12 is an antioxidant, as per recent research, and a low vitamin B-12 level might be a contributing factor to oxidative stress, particularly in diabetic patients. Vitamin B-12 is an antioxidant and anti-inflammatory substance that may influence oxidative stress responses, including inflammatory reactions. As a result, the goal of this research was to study at possible associations between vitamin B-12 status and inflammation in Type 2 diabetes mellitus who are on metformin and on metformin with other associated anti-diabetic drugs. Aims and Objectives: In our study we tried to see the association between serum B12 levels and proinflammatory cytokines which lead to many macrovascular complications like cardiovascular diseases, renal failure etc. Materials and Methods: The present study recruited 500 participants between 30 and 65 years of age. patient pool who has been recently diagnosed as type 2 diabetics on metformin usage for more than 12 to 18 months. The study design was divided into 3 groups: A, B, and C. Group A consisted of 200 subjects with type 2 diabetes only on metformin with a daily dosage of 500 mg/day, and Group B consisted of 200 subjects with type 2 diabetes who were on both metformin with a daily dosage of 500 mg/day and other anti-diabetic drugs of around 2 mg/day. Both groups A and B had no other complications from diabetes. Group C included controls, consisting of 100 healthy individuals with no history of diabetes. Results: The percentages of Serum B12, in both male and female groups were significantly decreased in cases and consequently, inflammatory markers like leptin, IL-6, hsCRP, TNF-α were significantly increased who were on metformin than who were on metformin and other associated drug group. Conclusions: Findings from this study clearly indicates the link between decrease in B12 and progression of inflammation. the role of metformin in vitB12 deficiency levels, uncontrolled glucose levels, and chronic inflammatory responses in T2DM patients, gradually leading to the dire consequences of B12 deficiency.

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