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.
Keywords
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Article info
Publication history
Published online: July 09, 2012
Accepted:
June 12,
2012
Received in revised form:
May 17,
2012
Received:
February 27,
2012
Identification
Copyright
© 2012 Elsevier Ireland Ltd. Published by Elsevier Inc. All rights reserved.
