PT  - JOURNAL ARTICLE
AU  - Pflipsen, Matthew C.
AU  - Oh, Robert C.
AU  - Saguil, Aaron
AU  - Seehusen, Dean A.
AU  - Seaquist, Derek
AU  - Topolski, Richard
TI  - The Prevalence of Vitamin B<sub>12</sub> Deficiency in Patients with Type 2 Diabetes: A Cross-Sectional Study
AID  - 10.3122/jabfm.2009.05.090044
DP  - 2009 Sep 01
TA  - The Journal of the American Board of Family Medicine
PG  - 528--534
VI  - 22
IP  - 5
4099  - http://www.jabfm.org/content/22/5/528.short
4100  - http://www.jabfm.org/content/22/5/528.full
SO  - J Am Board Fam Med2009 Sep 01; 22
AB  - 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.