Infante M, Leoni M, Caprio M, Fabbri A. Long-term metformin therapy and vitamin B12 deficiency: An association to bear in mind. World J Diabetes 2021; 12(7): 916-931 [PMID: 34326945 DOI: 10.4239/wjd.v12.i7.916]
Corresponding Author of This Article
Marco Infante, MD, FACN, Adjunct Professor, UniCamillus, Saint Camillus International University of Health Sciences, Via di Sant’Alessandro 8, Rome 00131, Italy. marco.infante@unicamillus.org
Research Domain of This Article
Endocrinology & Metabolism
Article-Type of This Article
Field of Vision
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Diabetes. Jul 15, 2021; 12(7): 916-931 Published online Jul 15, 2021. doi: 10.4239/wjd.v12.i7.916
Long-term metformin therapy and vitamin B12 deficiency: An association to bear in mind
Marco Infante, Martina Leoni, Massimiliano Caprio, Andrea Fabbri
Marco Infante, UniCamillus, Saint Camillus International University of Health Sciences, Rome 00131, Italy
Marco Infante, Martina Leoni, Andrea Fabbri, Diabetes Research Institute Federation (DRIF), Division of Endocrinology and Diabetes, CTO Alesini Hospital, Department of Systems Medicine, University of Rome Tor Vergata, Rome 00145, Italy
Marco Infante, Network of Immunity in Infection, Malignancy and Autoimmunity (NIIMA), Universal Scientific Education and Research Network (USERN), Rome 00145, Italy
Massimiliano Caprio, Department of Human Sciences and Promotion of the Quality of Life, San Raffaele Roma Open University, Rome 00166, Italy
Massimiliano Caprio, Laboratory of Cardiovascular Endocrinology, IRCCS San Raffaele Pisana, Rome 00166, Italy
Author contributions: Infante M conceived and wrote the manuscript; Leoni M contributed to the literature search; Caprio M and Fabbri A revised the final version of the manuscript.
Conflict-of-interest statement: The authors declare that they have no competing interests.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Marco Infante, MD, FACN, Adjunct Professor, UniCamillus, Saint Camillus International University of Health Sciences, Via di Sant’Alessandro 8, Rome 00131, Italy. marco.infante@unicamillus.org
Received: January 29, 2021 Peer-review started: January 29, 2021 First decision: March 16, 2021 Revised: March 21, 2021 Accepted: April 29, 2021 Article in press: April 29, 2021 Published online: July 15, 2021
Core Tip
Core Tip: Over the last decades, vitamin B12 deficiency has been increasingly recognized as a possible consequence of long-term metformin therapy, potentially resulting in clinical manifestations such as hematologic abnormalities and peripheral neuropathy. Metformin-induced vitamin B12 deficiency has relevant implications in light of the growing population of individuals on metformin therapy for the treatment of type 2 diabetes, prediabetes, insulin resistance and polycystic ovary syndrome on a global scale. Notwithstanding, no definite guidelines are currently available for vitamin B12 deficiency screening in metformin-treated patients. We therefore propose a list of criteria for cost-effective vitamin B12 deficiency screening in metformin-treated patients.
