CORRELATION AND PREVALENCE OF MEGALOBLASTIC ANAEMIA IN TYPE 2 DIABETIC PATIENTS USING METFORMIN

Abstract

Background: Metformin is the most widely used drug in the management of type 2 diabetic patients but its use is associated with vitamin B₁₂ deficiency induced megaloblastic anaemia. However few studies in Pakistan have assessed this risk. This study was conducted to determine correlation and prevalence of megaloblastic anaemia in type 2 diabetics treated with metformin. Methods: This cross-sectional study was carried out in the Department of Medicine, Hayatabad Medical Complex, Peshawar from Dec 2021 to Nov 2022. A total of 156 type 2 diabetic patients who were taking metformin at least for the last 2 years, were included in the study. All these patients were evaluated for anaemia, raised Mean Corpuscular Volume (MCV) and vitamin B₁₂ levels. Results: Out of 156 patients who participated in the study, 94 (60.25%) were male and 62 (39.75%) were female with a mean age of 57.56±8.5 years. Mean duration of diabetes was 7.37±3.61 years, whereas mean duration of metformin use was 5.85±2.9 years. Vitamin B₁₂ deficiency was identified in 51 (32.69%) patients. These B₁₂ deficient patients demonstrated a mean Hb of 9.8±1.4 g/dL. Hyper-segmented neutrophils and raised MCV (mean MCV 98.7±6.90 fl was also identified in them. There was a no correlation between serum B₁₂ levels and dose and duration of metformin. Conclusion: Long term metformin use is significantly associated with B₁₂ deficiency associated megaloblastic anaemia.

Diabetes Mellitus, Metformin, HbA1_C, Vitamin B₁₂, Megaloblastic Anaemia

Pak J Physiol 2023;19(3):23–6