Метформин-индуцированный дефицит кобаламина (вит. В12)

[Dr.Vad]

Pекомендации по диагностике и ведению данной проблемы в недавней публикации:

Diabetes Res Clin Pract. 2012 Jul 7.
Recommendations for diagnosis and management of metformin-induced vitamin B12 (Cbl) deficiency.
Mazokopakis EE, Starakis IK.
Department of Internal Medicine, Naval Hospital of Crete, 73 200 Chania, Crete, Greece.

Metformin treatment is a known pharmacological cause of vitamin B12 (Cbl) deficiency with controversial responsible mechanisms. A possible diagnosis of this deficiency is based mainly on the combination of patient's medical history (usually long-term metformin use), clinical examination (possible neuropsychiatric symptoms and signs), laboratory studies which confirm a Cbl deficiency (haematological abnormalities, low serum Cbl levels, elevated serum total homocysteine and methylmalonic acid levels), and exclusion other causes of Cbl deficiency (as pernicious anaemia, food-cobalamin malabsorption syndrome, other drugs, etc.). In our review, recommendations for diagnosis and management of metformin-induced Cbl deficiency (MICD) in diabetic patients based on medical bibliography are presented and discussed.

Альтернативный подход - ежегодная профилактика В12-дефицита в др. полнотекстовой статье:

J Young Pharm. 2010 Oct;2(4):428-9.
Revisiting Metformin: Annual Vitamin B12 Supplementation may become Mandatory with Long-Term Metformin Use

[Ссылки доступны только зарегистрированным пользователям ]

Или добавление кальция к метформину может препятствовать риску развития кобаламино-дефицита:

Diabetes Care. 2000 Sep;23(9):1227-31.
Increased intake of calcium reverses vitamin B12 malabsorption induced by metformin.

[Ссылки доступны только зарегистрированным пользователям ]