To Investigate The Effects Of Metformin On Serum Vitamin B12 In Patients With Diabetes And Peripheral Neuropathy

[Objective] To investigate the effects of metformin on serum vitamin B12 levels and diabetic peripheral neuropathy(DPN) the effects of related factors ofvitamin B12 and DPN risk factors, so as to provide clinical basis for the clinical prevention and treatment and treatment by metformin or cause vitamin B12 decreased the occurrence and development of the cause or aggravate DPN.[ Methods] Selected 120 cases of 2013 July to 2014 November in the Department of endocrinology of Affiliated Hospital of Yan’an University outpatient andhospitalized type 2 diabetes patients, male 50 cases, female 70 cases;the minimum age of 27 years old, the biggest 73 years old, the shortest duration of diabetes a month, the longest 14 years The diagnosis of diabetes meet the following 3 diagnostic criteria for an arbitrary and confirm a. The symptoms of diabetes and random blood glucose level greater than or equal to 11.1mmol/L, and the levels of fasting blood glucose(FBP) level greater than or equal to7 mmol/L, or the oral glucose tolerance test(OGTT), 2 hour blood glucose level greater than or equal to 11.1mmol/L. According to the application of metformin were divided into group(metformin use recent history of atleast 6 months) andthe non metformin group(without the use of metformin in 6months),according to the DPN diagnostic criteria of metformi-n group was divided into DPN, NDPN, the non metformin group was divided into DPN, NDPN.All patients were inquired and recorded the name, age, gender, history of diabetes, metformin and other drug use history, there is no pernicious anemia, intes tinal operation, cervical vertebra, lumbar disease and otherdiseases; the usual eating habits;whether associated with DPNsymptoms, such as acralparesthesia, numbness, pa in, and record thehistory of DPN. All patients clinical data collected in the fasting stat e, andaccurate records of blood pressure, height, weight, body mass index(kg)and BMI(weight / height 2(kg/, M2) from venous blood determination offolic acid, inclu ding check anemia related to vitamin B12, ferritin,hemoglobin(HGB), blood routine examination including meancorpuscular volume(MCV), renal function including bloo d urea nitrogen(Urea), creatinine(Cre), blood lipid including triglyceride(TG), high d ensity lipoprotein(HDL-C), low density lipoprotein(LDL-C), total cholesterol(TC), a nd homocysteine(Hcy) and glycosylated hemoglobin(Hb AIc). The use of SPSS17.0 st atistical analysis software for statistical processing of experimental data, using X + s measurement data using t test, analysis and other data of two samples of vitami n B12 levels, using the chi square test(x2) analysis of the two groups in the incid ence of DPN, related factors of vitamin B12 with linear correlation analysis, risk factor s for DPN by using non conditional logistic regression analysis. P is less than 0.05, the difference was statistically significant.[Results] 1, the metformin group serum B12 and HGB levels were lower than those of the non metformin group, the difference was statistically significant. 2, the level of serum Hcy and DPN in metformin group was higher than that in the non metformin group, the difference was statistically significant. 3, the test group in age, gender, blood pressure, body mass index and other data showed no significant difference. 4, folic acid, iron protein and vitamin B12 levels had a positive linea r correlatio n, duration of diabetes, Hcy and vitamin B12 were negatively correlated. 5, duration of diabetes, HbAIc, Hcy, vitamin Bl2 is a risk factor of DPN.[Conclusion] 1, long-term use of metformin in diabetic patients may be reduced or lack of vitamin Bl2 levels and cause or aggravate the occurrence and development of DPN one of the drugs cause.2, the rise of Hcy is a sensitive index of vitamin B12 level decreased or absent, the two combined detection helps to early detection of vitamin B12 levels. 3, folic acid, iron protein is helpful to evaluate the level of vitamin B12. 4, the longer the duration of diabetes patients with poor glycemic control,overall, low vitamin B12 levels, Hcy levels may promote DPN. This study suggests that the long-term use of metformin in these high-risk patients based on blood glucose level, suggest that regular monitoring of vitamin B12 levels, and related factors of Hcy, folic acid,and regular screening for DPN, and gives therelated corresponding positiveintervention, which can reduce or delay caused by metformin in the occurrence and development of DPN in a certain degree.