Abstract

Diabetes mellitus (DM) refers to a group of common metabolic disorders that share the phenotype of hyperglycemia. Depending upon the etiology of DM, factors contributing to hyperglycemia include reduced insulin secretion, decreased glucose utilization and increased glucose production. Objective: To study the hematological parameters and vitamin B12 level in type 2 diabetics on long term metformin therap. Material and Methods: The present prospective observational case control study was carried out at tertiary care centre of central India from Jan 2021 to December 2022. Approval from the Institutional Ethics Committee was sought. Informed consent in subject’s vernacular language was taken. Sample size was 204 (102 in each group – case and control). Results: 67.44 % (29/43) vitamin B12 deficient cases had macrocytes in their peripheral smear which was statistically significant. The mean vitamin B 12 level was lower in cases than in controls which was statistically significant.( p value <0.05). 42.1% (43/102) cases and 10.7% (11/102) controls had vitamin B12 deficiency. As compared to the control group, more subjects in Diabetic group had vitamin B12 deficiency which was statistically significant. Age was seen to be positively associated with the incidence of Vitamin B12 deficiency. 51.9% (53/102) of cases had diabetes for less than 10 years and 48.1% (49/102) of cases had diabetes for more than 10 years. 52.9% (54/102) diabetic cases were on metformin therapy for less than 10 years and 47.1% (48/102) cases were on metformin therapy for more than 10 years. Prolonged duration of Metformin therapy significantly associated with serum vitamin B12 deficiency. (p value <0.01). Conclusion: In the present study, prolong duration of diabetes and prolong use of metformin were associated with vitamin B12 deficiency. Macrocytosis was correlated with vitamin b12 dficiency.

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