Diabetes, metformin, vitamin B12

Metformin remains the best treatment for type 2 diabetes but every patient taking it should have his or her vitamin B12 levels assessed regularly to avoid peripheral neuropathy.

Currently, there are no official guidelines on the screening for vitamin B12 levels in these patients, but if metformin is recommended for the first-line treatment, its long-term use can lead to vitamin B12 deficiency with increased risk of peripheral neuropathy.
Patients taking metformin should be tested for vitamin B12 levels before starting treatment, as well as during follow-up.


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