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Do we need to measure vitamin B12 and magnesium in morbidly obese patients with type 2 diabetes mellitus?

Authors Wåhlén A, Haenni A, Johansson HE

Received 30 December 2016

Accepted for publication 23 March 2017

Published 2 May 2017 Volume 2017:10 Pages 151—154

DOI https://doi.org/10.2147/DMSO.S131340

Checked for plagiarism Yes

Review by Single-blind

Peer reviewers approved by Dr Colin Mak

Peer reviewer comments 4

Editor who approved publication: Professor Ming-Hui Zou

Anna Wåhlén,1 Arvo Haenni,2,3 Hans-Erik Johansson1–3

1Östervåla Primary Health Care Centre, Östervåla, 2Department of Public Health and Caring Sciences/Geriatrics, Uppsala University, Uppsala, 3Skönvikt, Outpatient Clinic of Obesity Care, Säter, Sweden

Objective: We aimed to investigate the prevalence of B12 deficiency in metformin-treated, morbidly obese, type 2 diabetes mellitus (T2DM) patients, compared to morbidly obese controls, as well as to evaluate the magnesium status.
Design:
Retrospective cross-sectional analysis of plasma vitamin B12, plasma magnesium, glucometabolic status and clinical measurements in all consecutive morbidly obese patients was conducted during 1 year.
Setting:
Outpatient Clinic of Obesity Care.
Subjects: One hundred forty-seven patients were evaluated: 107 morbidly obese controls and 40 metformin-treated, morbidly obese patients with T2DM.
Main outcome measures: Circulating plasma concentrations of vitamin B12 (cobalamin), magnesium, clinical measurements and metformin medication.
Results: There were differences between the two groups regarding age, sagittal diameter, glucose parameters and magnesium concentrations. Longer diabetes duration was associated with lower magnesium. Metformin-treated T2DM patients had lower magnesium (0.76±0.07 mmol/L) than controls (0.82±0.07 mmol/L). A subgroup analysis of 26 non-metformin-treated T2DM patients showed a normal magnesium concentration compared to controls, that is, 0.81±0.06 mmol/L. We found no statistical difference in B12 concentrations between the two groups.
Conclusion: To fully benefit from metformin medication, routine testing of B12 as well as magnesium in metformin-treated, morbidly obese patients should be performed, with consideration of substitution to avoid low levels.

Keywords: metformin medication, vitamin B12, magnesium, type 2 diabetes mellitus, morbidly obese

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