{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,24]],"date-time":"2026-09-24T04:35:21Z","timestamp":1790224521846,"version":"4.1.0"},"reference-count":67,"publisher":"Oxford University Press (OUP)","issue":"4","license":[{"start":{"date-parts":[[2023,5,11]],"date-time":"2023-05-11T00:00:00Z","timestamp":1683763200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100019779","name":"Qatar National Library","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100019779","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2024,3,11]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:p>Over the last decades, low vitamin\u2009B12 status has been reported in individuals with type 2 diabetes mellitus (T2DM). Metformin, the first-line therapy for lowering blood glucose, is the main driving factor behind this association. Although the relationship between vitamin\u2009B12 deficiency and metformin is well established, results of studies on the exact effect of the dose and duration of the therapy remain inconsistent. Additionally, a lack of consensus on the definition of vitamin\u2009B12 deficiency adds to the conflicting literature. The objectives of this review were to analyze and synthesize the findings on the effects of metformin dose and duration on vitamin\u2009B12 status in patients with T2DM and to outline the potential mechanisms underlying metformin\u2019s effect on vitamin\u2009B12. Metformin therapy has adversely affected serum vitamin\u2009B12 concentrations, a marker of vitamin\u2009B12 status. The metformin usage index (a composite score of metformin dose and duration) might serve as a potential risk assessment tool for vitamin B12 screening in patients with T2DM. Considering the health implications of suboptimal vitamin\u2009B12 status, vitamin\u2009B12 concentrations should be monitored periodically in high-risk patients, such as vegans who are receiving metformin therapy for T2DM. Additionally, it is prudent to implement lifestyle strategies concurrent with metformin therapy in individuals with T2DM, promoting an overall synergistic effect on their glycemic control.<\/jats:p>","DOI":"10.1093\/nutrit\/nuad045","type":"journal-article","created":{"date-parts":[[2023,5,11]],"date-time":"2023-05-11T19:17:09Z","timestamp":1683832629000},"page":"553-560","source":"Crossref","is-referenced-by-count":18,"title":["Impact of metformin treatment on cobalamin status in persons with type 2 diabetes"],"prefix":"10.1093","volume":"82","author":[{"given":"Sundus","family":"Fituri","sequence":"first","affiliation":[{"name":"Human Nutrition Department, College of Health Sciences, QU Health, Qatar University , Doha, Qatar"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zoha","family":"Akbar","sequence":"additional","affiliation":[{"name":"Human Nutrition Department, College of Health Sciences, QU Health, Qatar University , Doha, Qatar"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6314-7734","authenticated-orcid":false,"given":"Vijay","family":"Ganji","sequence":"additional","affiliation":[{"name":"Human Nutrition Department, College of Health Sciences, QU Health, Qatar University , Doha, Qatar"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2023,5,11]]},"reference":[{"key":"2024031108152108800_nuad045-B1","doi-asserted-by":"crossref","first-page":"1266","DOI":"10.3181\/0703-MR-67","article-title":"Vitamin B12 sources and bioavailability","volume":"232","author":"Watanabe","year":"2007","journal-title":"Exp Biol Med (Maywood)"},{"key":"2024031108152108800_nuad045-B2","doi-asserted-by":"crossref","first-page":"195","DOI":"10.1111\/j.1365-2141.2009.07937.x","article-title":"Advances in the understanding of cobalamin assimilation and metabolism","volume":"148","author":"Quadros","year":"2010","journal-title":"Br J Haematol"},{"key":"2024031108152108800_nuad045-B3","doi-asserted-by":"crossref","first-page":"1995S","DOI":"10.1093\/jn\/nxy201","article-title":"Biomarkers of Nutrition for Development (BOND): vitamin B-12 review","volume":"148","author":"Allen","year":"2018","journal-title":"J Nutr"},{"key":"2024031108152108800_nuad045-B4","doi-asserted-by":"crossref","first-page":"330","DOI":"10.1024\/0300-9831\/a000041","article-title":"Bioavailability of vitamin B12","volume":"80","author":"Allen","year":"2010","journal-title":"Int J Vitam Nutr Res"},{"key":"2024031108152108800_nuad045-B5","doi-asserted-by":"crossref","first-page":"5031","DOI":"10.3390\/nu5125031","article-title":"Neuroenhancement with vitamin B12-underestimated neurological significance","volume":"5","author":"Gr\u00f6ber","year":"2013","journal-title":"Nutrients"},{"key":"2024031108152108800_nuad045-B6","doi-asserted-by":"publisher","first-page":"74","DOI":"10.3390\/nu10010074","article-title":"Population reference values for serum methylmalonic acid concentrations and its relationship with age, sex, race-ethnicity, supplement use, kidney function and serum vitamin B12 in the post-folic acid fortification period","volume":"10","author":"Ganji","year":"2018","journal-title":"Nutrients"},{"key":"2024031108152108800_nuad045-B7","doi-asserted-by":"crossref","first-page":"239","DOI":"10.1016\/0002-9343(94)90149-X","article-title":"Sensitivity of serum methylmalonic acid and total homocysteine determinations for diagnosing cobalamin and folate deficiencies","volume":"96","author":"Savage","year":"1994","journal-title":"Am J Med"},{"key":"2024031108152108800_nuad045-B8","doi-asserted-by":"crossref","first-page":"289","DOI":"10.1016\/j.jjcc.2012.11.009","article-title":"Vitamin B12 deficiency and hyperhomocysteinemia as correlates of cardiovascular risk factors in Indian subjects with coronary artery disease","volume":"61","author":"Mahalle","year":"2013","journal-title":"J Cardiol"},{"key":"2024031108152108800_nuad045-B9","doi-asserted-by":"crossref","first-page":"145","DOI":"10.7861\/clinmedicine.15-2-145","article-title":"Vitamin B12 deficiency - 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