Vitamin B12 (Cyanocobalamin), a water-soluble vitamin, has a vital
function in the metabolism of the body as it plays an important role in the
synthesis of DNA, and myelin (1). The clinical picture of vitamin B12
deficiency, is based mainly on hematological and neuro-cognitive
dysfunction (2). In general, vitamin B12 deficiency is related to certain
conditions such as obesity, gastrointestinal disease, bariatric surgery, and
renal insufficiency (3), (4), (5). Further studies reported an association
between vitamin B12 deficiency and old age (6), low income (7) certain
ethnic groups (8), and lifestyle factors, such as caffeine, or tobacco (9)
consumption of alcohol, and a sedentary lifestyle (4). The regular use of
medications, such as metformin (10) and proton pump inhibitors (11),
may be a reason of low vitamin B12. In type 2 diabetes mellitus (DM),
several cross-sectional studies have reported an increased frequency of
vitamin B12 deficiency (12). Metformin therapy has been established as a
primary factor of vitamin B12 deficiency among patients with type 2 DM
(2), resulting from malabsorption of the vitamin in this situation (13).
Vitamin B12 deficiency in metformin users has been related to the
duration, dose of therapy (14), and older age group (15). Type 1 DM is an
auto-immune disorder resulting from auto-immune destruction of beta
cells of the pancreas (16). It is well known that pernicious anemia,
resulting from chronic autoimmune gastritis, is highly frequent among
patients with type 1 DM with presence of auto antibodies to intrinsic
factor (17) and parietal cell (18). Therefore, vitamin B12 deficiency
occurs frequently among patients with type 1 DM (16). Moreover,
primary autoimmune hypothyroidism, and celiac disease (19) are
common comorbidities in type 1 diabetes that affect vitamin B 12 level.
This study was undertaken to establish the prevalence of B12 deficiency
in patients with DM in Benha Univeristy Hospital, Egypt, and to evaluate
the accompanying factors of vitamin B12 deficiency in those patients.
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