Deficiency of Vitamin B12 puts Diabetics at Risk for Diabetic Nerve Damage
Diabetics are at high risk for diabetic peripheral neuropathy, which is diabetic nerve damage. A British study was presented November 21, 2018 at the Society for Endocrinology annual conference in Glasgow. The results of their research suggest that earlier detection of Vitamin B12 deficiency through routine screening of all type-2 diabetes patients being treated with Metformin could lower their risk of developing diabetic neuropathy.
Hucknall Road Medical Center, Nottingham
The study was based on screening carried out by Dr Kaenet Mulla and other GP doctors at the Hucknall Road Medical Center in Nottingham, UK. Participants in the study were female patients with type 2 diabetes who were being treated with Metformin. The researchers checked if their blood levels of Vitamin B12 were sufficient. Results showed:
64% of the patients had never had their Vitamin B12 levels checked.
9.6% of the patients were found to be deficient for Vitamin B12, but only 6.4% were being treated with supplemental Vitamin B12.
What is Diabetic Peripheral Neuropathy
According to the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), about half of people with diabetes will develop diabetic peripheral neuropathy. This is a form of diabetic nerve damage most commonly found in the feet and legs. This can lead to disabling pain or numbness and the inability to feel pain in the feet and legs. It may also cause tingling, burning and feelings like pins and needles. However, it may also affect the arms and hands. Different forms of diabetic neuropathy can cause symptoms in the face and even in organs like the heart and bladder.
Diabetics can Lose Feeling in their Feet and Legs
Numbness can reach the point where the diabetic loses so much feeling in their feet and legs that they can no longer feel pain at all. If they get a pebble in their shoe or any kind of splinter or blister they simply do not feel these even when they lead to wounds. Some of these wounds go totally unnoticed until they develop into a diabetic foot ulcer.
Diabetic Foot Ulcers can Lead to Amputations
Diabetic foot ulcers can become chronic and refuse to heal. They can also become infected with gangrene and then the foot or leg needs to be amputated. According to the Centers for Disease Control and Prevention (CDC), diabetes is the leading cause for lower limb amputations in the United States.
Metformin Linked to Deficiency of Vitamin B12
Metformin is the most commonly prescribed drug for controlling glucose (sugar) levels in people with diabetes. However, Metformin has been linked to a complication that may go unnoticed, but can lead to very bad outcomes. Metformin can lead to a deficiency of Vitamin B12 in the body. Insufficient Vitamin B12 can lead to diabetic neuropathy.
According to the National Institutes of Health (NIH), a previous study showed that diabetics who took Metformin for over 4 years had a 19% decreased level of Vitamin B12 and had a 7.2% risk for Vitamin B12 deficiency.
More about Vitamin B12 Cobalamin
Vitamin B12 Cobalamin is a water-soluble vitamin that is part of the B-complex vitamins. Unlike other B-complex vitamins that are commonly found in both the plant and animal worlds, vitamin B12 is only found in animal derived foods like seafood, fish, liver, meat, poultry, eggs and dairy products. For this reason vegans (people who only eat plant foods) are at risk for being deficient in Vitamin B12. Vegans may have to supplement with Vitamin B12. Vitamin B12 is most effectively absorbed when it is dissolved under the tongue. This allows it to be absorbed without having to go through the digestive tract.
However, sometimes Vitamin B12 is added to plant derived foods like nutritional yeast. Brewer’s yeast and nutritional yeast are one of the best food sources for B-complex vitamins, but they are lacking Vitamin B12, so some food companies ad it to their products.
Malabsorption of Vitamin B12
While some people eat foods that are abundant in Vitamin B12, their body has a problem absorbing it. This can be in people who do not have enough hydrochloric acid in their stomachs, which is necessary for proper absorption. People who take proton pump inhibitors and H2 receptor antagonists for acid reflux problems may be at risk for decreased levels of Vitamin B12. Also, the antibiotic chloramphenicol used to treat some kinds of infections can lead to reduced levels of Vitamin B12.
Adequate Vitamin B12 is Needed for Several Proper Functions in the Body
Adequate Vitamin B12 is needed for several proper functions in the human body such as:
- The formation of red blood cells in bone marrow. People who are deficient can develop pernicious and megaloblastic anemia.
- Normal functioning of the nervous system
- DNA synthesis
- Metabolism of fatty acids and amino acids
- Good mental health
- Preventing cognitive decline
Diabetes in the United States
According to the Centers for Disease Control and Prevention (CDC):
- More than 30 million people in the United States have diabetes and 1 in 4 of them do not know they have it.
- More than 84 million US adults (a third) have prediabetes, and 90% of them do not know they have prediabetes.
- Diabetes is the 7th leading cause of death in the United States (and may be under reported).
- Type 2 diabetes accounts for about 90% to 95% of all diagnosed cases of diabetes; Type 1 diabetes accounts for about 5%.
- In the last 20 years, the number of adults diagnosed with diabetes has more than doubled as the American population has aged and become more overweight or obese.
Risks for Developing Prediabetes or Type 2 Diabetes
The risks for developing prediabetes or type 2 diabetes are:
- Being overweight or obese
- Age 45 or older
- A family history especially a parent, brother or sister with type 2 diabetes
- Not enough physical activity and exercise
- A woman who had gestational diabetes (diabetes while pregnant) or gave birth to a baby that weighed more than 9 pounds
- African Americans, Hispanic/Latino Americans, American Indians/Alaska Natives, Pacific Islanders, and some Asian Americans are at higher risk for prediabetes and type 2 diabetes.
Complications from Diabetes
- People with diabetes are twice as likely to have heart disease or a stroke as people without diabetes and at an earlier age.
- Diabetes is the leading cause of chronic kidney disease in the United States
- Diabetes is the leading cause for adult-onset blindness.
- As was mentioned above, diabetes is the leading cause for lower-limb amputations,
- Smokers are 30-40% more likely to develop type 2 diabetes than nonsmokers.
- People with diabetes who smoke are more likely to develop serious related health problems, including heart and kidney disease.
Cost of Diabetes
Medical costs, lost work and wages for people with diagnosed diabetes total $327 billion yearly.
Medical costs for people with diabetes are twice as high as for people who do not have diabetes.
Diabetes Monitoring, Diabetes Care and Complex Wound Care at the Park Crescent Healthcare and Rehabilitation Center in East Orange, New Jersey
The Park Crescent Healthcare and Rehabilitation Center in East Orange, New Jersey offers expert diabetes monitoring and care. They also are the main center in their area for people in need of state-of-the-art complex wound care. This includes chronic wounds and diabetic foot ulcers. See our blog post from February 1, 2019 about complex wound care at Park Crescent and about their amazing success even with chronic ulcers where the bones and tendons are exposed. Park Crescent specializes in hyperbaric oxygen therapy (HBOT) and this unique method of treatment results in very good outcomes of healing complex wounds.
Since Vitamin B12 is so important for everyone, especially for diabetics, it is important to do the simple blood test to make sure you have sufficient amounts. If you are found deficient, you will need to supplement Vitamin B12, as this can help to prevent or treat several kinds of disease conditions, including diabetic peripheral neuropathy. This can help to prevent amputations.