Study of relation between long term Metformin treatment and Vitamin B12 DeficiencyIn type 2 diabetic Patients

Abstract

Egypt has been among the top ten countries for number of people with diabetes representing a huge economic and social burden as people with diabetes are at risk of developing a number of disabling and life threating health problem. Metformin is a first-line oral anti-diabetic agent that has been used clinically to treat patients with type 2 diabetes for over 60 years. Due to its efficacy in therapy and affordable price, metformin is taken by more than 150 million people each year. Metformin improves hyperglycemia mainly through the suppression of hepatic gluconeogenesis along with the improvement of insulin signaling. Its mechanisms of action differ from those of other classes of oral antidiabetic agents; metformin works by decreasing hepatic gluconeogenesis production. It also decreases intestinal absorption of glucose and improves insulin sensitivity by increasing peripheral glucose uptake and utilization. Unlike oral sulfonylureas, metformin r