PMID- 37611751
OWN - NLM
STAT- MEDLINE
DCOM- 20231107
LR  - 20240104
IS  - 1530-891X (Print)
IS  - 1530-891X (Linking)
VI  - 29
IP  - 11
DP  - 2023 Nov
TI  - Effect of Metformin Use on Vitamin B12 Deficiency Over Time (EMBER): A Real-World 
      Evidence Database Study.
PG  - 862-867
LID - S1530-891X(23)00526-8 [pii]
LID - 10.1016/j.eprac.2023.06.013 [doi]
AB  - OBJECTIVE: To examine the extent to which metformin increases the risk of vitamin 
      B12 deficiency and borderline deficiency over time in participants with type 2 
      diabetes mellitus (T2DM). METHODS: Using the All of Us database, adults aged >/=18 
      years with T2DM and a documented history of metformin use were included for the 
      evaluation of B12 deficiency. Those with B12 deficiency before metformin use were 
      excluded. Adjusted logistic regression models were used to evaluate the 
      association between metformin use and long-term metformin use (>/=4 years) and the 
      risk of B12 deficiency. We conducted a subgroup analysis comparing differences in 
      borderline B12 deficiency in metformin and non-metformin users. RESULTS: Of 
      36 740 participants with T2DM, 6221 (16.9%) had documented metformin use. The 
      mean age of metformin users was 65.3 years. B12 deficiency was confirmed in 464 
      (7.5%) metformin users, and 1919 of 30 519 participants (6.3%) did not use 
      metformin. Metformin users had a 4.7% increased risk of developing B12 deficiency 
      compared with nonmetformin users (P = .44). Each additional year of metformin use 
      was associated with 5% increased likelihood of deficiency (P < .05). Metformin 
      use for >/=4 years resulted in a 41.0% increased odds of B12 deficiency, compared 
      with those who used <4 years of metformin (P < .05). Metformin use increased the 
      odds of borderline B12 deficiency by 27.0% (P < .05). CONCLUSION: Long-term 
      metformin use was associated with an increased risk of B12 deficiency in patients 
      with T2DM, with compounding risk over time.
CI  - Copyright (c) 2023 AACE. Published by Elsevier Inc. All rights reserved.
FAU - Hurley-Kim, Keri
AU  - Hurley-Kim K
AD  - Department of Clinical Pharmacy Practice, University of California, Irvine School 
      of Pharmacy & Pharmaceutical Sciences, Irvine, California.
FAU - Vu, Chuong Hoang
AU  - Vu CH
AD  - University of California, Irvine, California.
FAU - Dao, Nhat Minh
AU  - Dao NM
AD  - University of California, Irvine, California.
FAU - Tran, Lam Chau
AU  - Tran LC
AD  - University of California, Irvine, California.
FAU - McBane, Sarah
AU  - McBane S
AD  - Department of Clinical Pharmacy Practice, University of California, Irvine School 
      of Pharmacy & Pharmaceutical Sciences, Irvine, California.
FAU - Lee, Joyce
AU  - Lee J
AD  - Department of Clinical Pharmacy Practice, University of California, Irvine School 
      of Pharmacy & Pharmaceutical Sciences, Irvine, California.
FAU - Sepassi, Aryana
AU  - Sepassi A
AD  - Department of Clinical Pharmacy Practice, University of California, Irvine School 
      of Pharmacy & Pharmaceutical Sciences, Irvine, California. Electronic address: 
      asepassi@hs.uci.edu.
LA  - eng
PT  - Journal Article
DEP - 20230821
PL  - United States
TA  - Endocr Pract
JT  - Endocrine practice : official journal of the American College of Endocrinology 
      and the American Association of Clinical Endocrinologists
JID - 9607439
RN  - 9100L32L2N (Metformin)
RN  - 0 (Hypoglycemic Agents)
SB  - IM
EIN - Endocr Pract. 2023 Nov 1;:. PMID: 37921778
MH  - Adult
MH  - Humans
MH  - Adolescent
MH  - Aged
MH  - *Metformin/adverse effects
MH  - *Diabetes Mellitus, Type 2/drug therapy/epidemiology
MH  - Hypoglycemic Agents/adverse effects
MH  - *Population Health
MH  - *Vitamin B 12 Deficiency/chemically induced/epidemiology/complications
OTO - NOTNLM
OT  - adverse effect
OT  - cobalamin
OT  - deficiency
OT  - metformin
OT  - vitamin B12
COIS- Disclosure The authors have no multiplicity of interest to disclose.
EDAT- 2023/08/24 00:42
MHDA- 2023/11/07 06:45
CRDT- 2023/08/23 19:24
PHST- 2023/05/16 00:00 [received]
PHST- 2023/06/21 00:00 [revised]
PHST- 2023/06/22 00:00 [accepted]
PHST- 2023/11/07 06:45 [medline]
PHST- 2023/08/24 00:42 [pubmed]
PHST- 2023/08/23 19:24 [entrez]
AID - S1530-891X(23)00526-8 [pii]
AID - 10.1016/j.eprac.2023.06.013 [doi]
PST - ppublish
SO  - Endocr Pract. 2023 Nov;29(11):862-867. doi: 10.1016/j.eprac.2023.06.013. Epub 
      2023 Aug 21.