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Research ArticleOriginal Research

The Prevalence of Vitamin B12 Deficiency in Patients with Type 2 Diabetes: A Cross-Sectional Study

Matthew C. Pflipsen, Robert C. Oh, Aaron Saguil, Dean A. Seehusen, Derek Seaquist and Richard Topolski
The Journal of the American Board of Family Medicine September 2009, 22 (5) 528-534; DOI: https://doi.org/10.3122/jabfm.2009.05.090044
Matthew C. Pflipsen
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Robert C. Oh
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Aaron Saguil
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Dean A. Seehusen
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Derek Seaquist
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Richard Topolski
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This article has a correction. Please see:

  • Errata - September 01, 2010

Abstract

Purpose: The purpose of this study is to define the prevalence of vitamin B12 deficiency in a type 2 diabetic population within a primary care practice. Metformin use and advanced age are associated with vitamin B12 deficiency and often present in type 2 diabetic patients, yet the prevalence of vitamin B12 deficiency in the diabetic population is unknown.

Methods: We conducted a cross-sectional study of 203 outpatient type 2 diabetic patients at a large military primary care clinic. Patients completed a survey and had B12 levels measured. Patients with borderline B12 levels also had methylmalonic acid and homocysteine levels drawn. Serum B12 levels <100 pg/mL or serum B12 levels of 100 to 350 pg/mL with elevation of serum methylmalonic acid >243 nmol/L or homocysteine >11.9 nmol/L defined B12 deficiency. Descriptive statistics described frequency and means. χ2 and student's t tests were used to analyze associations between categorical and continuous variables, respectively. Multivariate logistical regression identified covariates independently associated with B12 deficiency.

Results: Twenty-two percent (n = 44) of diabetic patients had metabolically confirmed B12 deficiency. Patients on metformin had lower serum B12 levels (425.99 pg/mL vs 527.49 pg/mL; P = .012) and were at increased risk for B12 deficiency (P = .04), as defined by a serum B12 level <350 pg/mL. Prevalence of B12 deficiency was significantly lower for patients using a multivitamin (odds ratio, 0.31; 95% CI, 0.15–0.63).

Conclusions: Our results found a 22% prevalence of metabolically confirmed B12 deficiency in the primary care type 2 diabetic population. Although further research needs to be performed to determine the clinical implications of our findings, B12 deficiency should be considered in type 2 diabetic patients, especially those taking metformin. Furthermore, a daily multivitamin may protect against B12 deficiency.

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The Journal of the American Board of Family Medicine: 22 (5)
The Journal of the American Board of Family Medicine
Vol. 22, Issue 5
September-October 2009
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The Prevalence of Vitamin B12 Deficiency in Patients with Type 2 Diabetes: A Cross-Sectional Study
Matthew C. Pflipsen, Robert C. Oh, Aaron Saguil, Dean A. Seehusen, Derek Seaquist, Richard Topolski
The Journal of the American Board of Family Medicine Sep 2009, 22 (5) 528-534; DOI: 10.3122/jabfm.2009.05.090044

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The Prevalence of Vitamin B12 Deficiency in Patients with Type 2 Diabetes: A Cross-Sectional Study
Matthew C. Pflipsen, Robert C. Oh, Aaron Saguil, Dean A. Seehusen, Derek Seaquist, Richard Topolski
The Journal of the American Board of Family Medicine Sep 2009, 22 (5) 528-534; DOI: 10.3122/jabfm.2009.05.090044
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