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Assessment of vitamin B(12) deficiency and B(12) screening trends for patients on metformin: a retrospective cohort case review
OBJECTIVES: Our study investigated the use of vitamin B(12) testing in a large cohort of patients on metformin and assesses appropriateness and benefits of screening recommendations for vitamin B(12) deficiency. DESIGN: This retrospective cohort study included insured adult patients who had more tha...
Autores principales: | , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
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BMJ Publishing Group
2021
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Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8258036/ https://www.ncbi.nlm.nih.gov/pubmed/34308109 http://dx.doi.org/10.1136/bmjnph-2020-000193 |
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author | Martin, Darby Thaker, Jeet Shreve, Maria Lamerato, Lois Budzynska, Kartazyna |
author_facet | Martin, Darby Thaker, Jeet Shreve, Maria Lamerato, Lois Budzynska, Kartazyna |
author_sort | Martin, Darby |
collection | PubMed |
description | OBJECTIVES: Our study investigated the use of vitamin B(12) testing in a large cohort of patients on metformin and assesses appropriateness and benefits of screening recommendations for vitamin B(12) deficiency. DESIGN: This retrospective cohort study included insured adult patients who had more than 1 year of metformin use between 1 January 2010 and 1 October 2016 and who filled at least two consecutive prescriptions of metformin to establish compliance. The comparison group was not exposed to metformin. Primary outcome was incidence of B(12) deficiency diagnosed in patients on metformin. Secondary outcome was occurrence of B(12) testing in the patient population on metformin. Records dated through 31 December 2018 were analysed. SETTING: Large hospital system consisting of inpatient and outpatient data base. PARTICIPANTS: A diverse, adult, insured population of patients who had more than 1 year of metformin use between 1 January 2010 and 1 October 2016 and who filled at least two consecutive prescriptions of metformin. RESULTS: Of 13 489 patients on metformin, 6051 (44.9%) were tested for vitamin B(12) deficiency, of which 202 (3.3%) tested positive (vs 2.2% of comparisons). Average time to test was 990 days. Average time to test positive for deficiency was 1926 days. Factors associated with testing were linked to sex (female, 47.8%), older age (62.79% in patients over 80 years old), race (48.98% white) and causes of malabsorption (7.11%). Multivariable logistic regression showed older age as the only factor associated with vitamin B(12) deficiency, whereas African-American ethnicity approached significance as a protective factor. CONCLUSIONS: Based on our study’s findings of vitamin B(12) deficiency in patients on metformin who are greater than 65 years old and have been using it for over 5 years, we recommend that physicians consider screening in these populations. |
format | Online Article Text |
id | pubmed-8258036 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | BMJ Publishing Group |
record_format | MEDLINE/PubMed |
spelling | pubmed-82580362021-07-23 Assessment of vitamin B(12) deficiency and B(12) screening trends for patients on metformin: a retrospective cohort case review Martin, Darby Thaker, Jeet Shreve, Maria Lamerato, Lois Budzynska, Kartazyna BMJ Nutr Prev Health Original Research OBJECTIVES: Our study investigated the use of vitamin B(12) testing in a large cohort of patients on metformin and assesses appropriateness and benefits of screening recommendations for vitamin B(12) deficiency. DESIGN: This retrospective cohort study included insured adult patients who had more than 1 year of metformin use between 1 January 2010 and 1 October 2016 and who filled at least two consecutive prescriptions of metformin to establish compliance. The comparison group was not exposed to metformin. Primary outcome was incidence of B(12) deficiency diagnosed in patients on metformin. Secondary outcome was occurrence of B(12) testing in the patient population on metformin. Records dated through 31 December 2018 were analysed. SETTING: Large hospital system consisting of inpatient and outpatient data base. PARTICIPANTS: A diverse, adult, insured population of patients who had more than 1 year of metformin use between 1 January 2010 and 1 October 2016 and who filled at least two consecutive prescriptions of metformin. RESULTS: Of 13 489 patients on metformin, 6051 (44.9%) were tested for vitamin B(12) deficiency, of which 202 (3.3%) tested positive (vs 2.2% of comparisons). Average time to test was 990 days. Average time to test positive for deficiency was 1926 days. Factors associated with testing were linked to sex (female, 47.8%), older age (62.79% in patients over 80 years old), race (48.98% white) and causes of malabsorption (7.11%). Multivariable logistic regression showed older age as the only factor associated with vitamin B(12) deficiency, whereas African-American ethnicity approached significance as a protective factor. CONCLUSIONS: Based on our study’s findings of vitamin B(12) deficiency in patients on metformin who are greater than 65 years old and have been using it for over 5 years, we recommend that physicians consider screening in these populations. BMJ Publishing Group 2021-01-04 /pmc/articles/PMC8258036/ /pubmed/34308109 http://dx.doi.org/10.1136/bmjnph-2020-000193 Text en © Author(s) (or their employer(s)) 2021. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ. https://creativecommons.org/licenses/by-nc/4.0/This is an open access article 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, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/ (https://creativecommons.org/licenses/by-nc/4.0/) . |
spellingShingle | Original Research Martin, Darby Thaker, Jeet Shreve, Maria Lamerato, Lois Budzynska, Kartazyna Assessment of vitamin B(12) deficiency and B(12) screening trends for patients on metformin: a retrospective cohort case review |
title | Assessment of vitamin B(12) deficiency and B(12) screening trends for patients on metformin: a retrospective cohort case review |
title_full | Assessment of vitamin B(12) deficiency and B(12) screening trends for patients on metformin: a retrospective cohort case review |
title_fullStr | Assessment of vitamin B(12) deficiency and B(12) screening trends for patients on metformin: a retrospective cohort case review |
title_full_unstemmed | Assessment of vitamin B(12) deficiency and B(12) screening trends for patients on metformin: a retrospective cohort case review |
title_short | Assessment of vitamin B(12) deficiency and B(12) screening trends for patients on metformin: a retrospective cohort case review |
title_sort | assessment of vitamin b(12) deficiency and b(12) screening trends for patients on metformin: a retrospective cohort case review |
topic | Original Research |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8258036/ https://www.ncbi.nlm.nih.gov/pubmed/34308109 http://dx.doi.org/10.1136/bmjnph-2020-000193 |
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