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• The incidence of type 2 diabetes has been increasing at a rapid rate in the United States.

• Metformin is recommended as the first line treatment to be started at the time of diagnosis in all patients without contraindications and has been associated with vitamin B12 deficiency.

• There are currently no clinical guidelines for the routine monitoring of B12 levels in this population.

• The purpose of this scholarly project is to determine if there are consequences of this deficiency and to make recommendations for screening patients.

• It includes current research that focuses on the pathophysiology of a B12 deficiency, the prevalence and consequences of such a deficiency, and practices in monitoring patients for it.

• While many type 2 diabetics treated with metformin will develop a vitamin B12 deficiency, there may not be any consequences of this deficiency.

• More research is needed before universal guidelines can be established. At this point in time, monitoring B12 levels should be a decision based on individual patient’s risk factors and symptoms.


Physician Assistant Studies

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Master of Physician Assistant Studies (MPAS)

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Anemia -- chemically induced; Drug Monitoring; Hypoglycemic Agents -- adverse effects; Metformin -- adverse effects; Vitamin B 12 Deficiency -- complications


Endocrinology, Diabetes, and Metabolism | Pharmaceutical Preparations

Metformin and Vitamin B12 Deficiency: Consequences and Patient Monitoring