Letter to the Editor
Response to "More Adverse Neurological Consequences of Metformin-Induced Vitamin B12 Deficiency"
Abstract
To the Editor:
In my case report, my intention was to warn physicians that vitamin B12 deficiency could be induced with long-term metformin therapy.1The clinical findings in this case indicated that the neuropathy was entirely due to vitamin B12 deficiency and not to diabetes. Subsequently, Wile and Toth reported that metformin-induced vitamin B12 deficiency, as best assessed by methylmalonic acid (MMA) elevation, exacerbates diabetic neuropathy as judged by both clinical and electrophysiological parameters.2 Furthermore, these changes could occur as early as six months after metformin initiation.
This content is limited to qualifying members.
Existing members, please login first
If you have an existing account please login now to access this article or view purchase options.
Purchase only this article ($25)
Create a free account, then purchase this article to download or access it online for 24 hours.
Purchase an SMJ online subscription ($75)
Create a free account, then purchase a subscription to get complete access to all articles for a full year.
Purchase a membership plan (fees vary)
Premium members can access all articles plus recieve many more benefits. View all membership plans and benefit packages.