Vit B12 Status, Metformin, And The Risk And Severity Of Diabetic Comorbidities
VITAMIN B12 STATUS, METFORMIN, AND THE RISK AND SEVERITY OF DIABETIC COMORBIDITIES
Metformin treatment, both duration and dose, is associated with increased risk of inadequate vitamin B12 (B12) status. B12 deficiency causes hyperhomocysteinemia (HHcy), which is associated with an increased risk of a variety of diabetic co-morbidities, including neuropathy, nephropathy, retinopathy, and cardiovascular complications. The "Standards of Medical Care in Diabetes - 2017," issued by the American Diabetes Association, for the first time included a recommendation to periodically assess B12 status and, as needed, utilize B12 replacement therapy among diabetes patients receiving metformin.

Routine screening, using appropriate B12 assessment methods and their interpretation, would enable providers to identify individuals with low B12 status at an early stage. Prompt treatment with B12 injections or oral supplements may help in reducing the risk of low B12- and HHcy-related sequelae and their associate medical cost. The assessment of B12 status and interpretation of results is not straightforward since several B12 assessment measures are available, including serum/plasma B12, mean corpuscular volume, homocysteine, holotranscobalamin II and methylmalonic acid.
Upon successful completion of this one-hour course, the participant should be able to:
  • Summarize the recommendations for metformin treatment.


  • Review the impact of metformin treatment (both duration and dose) on vitamin B12 status.


  • Review available evidence regarding the impact of inadequate B12 and/or HHcy on diabetic comorbidities.


  • Describe available B12 assessment methods and summarize their advantages and disadvantages.


  • Propose interpretation of laboratory B12 biomarkers.


  • Discuss available B12 deficiency treatment options.
Live Webinar Date: Aug 18, 2020   (04:00 PM - 05:00 PM EST)
Performance Indicators/Learning Objectives: 4.2.6, 6.2.5, 6.3.8, 8.3.6
Target Audience: RDs, DTRs, Health Professionals
Number of Credits: 1.0
Level(s): 1, 2
Total Cost: $18

About the Presenter: Roman Pawlak, Ph.D, RD
Roman Pawlak

Associate Professor of Nutrition at East Carolina University. Authored: 'Vitamin B12. Combating the epidemic of deficiency' (published in English and Polish), 'Vegan/vegetarian mother and her baby' (published in English, Polish and Czech), 'I am the LORD who heals you' (published in English, Russian and Japanese), 'Forever young. Secrets of delaying aging and living disease free' (published in English and Polish), 'Healthy diet without secrets' (published in English and Polish), 'In defense of vegetarianism' (published in English and Polish), 'Diabetes. How to prevent it? How to cure it? How to prevent diabetes complications' (published in Polish), 'Diet – facts and myths' (published in Polish). Published in the best American and international nutrition journals, including, American Journal of Clinical Nutrition, European Journal of Clinical Nutrition, European Journal of Nutrition, Nutrition Reviews, American Journal of Preventive Medicine. Lectured in five continents, including North America, South America, Europe, Asia, and Africa.



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