- Home
- Medical news & Guidelines
- Anesthesiology
- Cardiology and CTVS
- Critical Care
- Dentistry
- Dermatology
- Diabetes and Endocrinology
- ENT
- Gastroenterology
- Medicine
- Nephrology
- Neurology
- Obstretics-Gynaecology
- Oncology
- Ophthalmology
- Orthopaedics
- Pediatrics-Neonatology
- Psychiatry
- Pulmonology
- Radiology
- Surgery
- Urology
- Laboratory Medicine
- Diet
- Nursing
- Paramedical
- Physiotherapy
- Health news
- AYUSH
- State News
- Andaman and Nicobar Islands
- Andhra Pradesh
- Arunachal Pradesh
- Assam
- Bihar
- Chandigarh
- Chattisgarh
- Dadra and Nagar Haveli
- Daman and Diu
- Delhi
- Goa
- Gujarat
- Haryana
- Himachal Pradesh
- Jammu & Kashmir
- Jharkhand
- Karnataka
- Kerala
- Ladakh
- Lakshadweep
- Madhya Pradesh
- Maharashtra
- Manipur
- Meghalaya
- Mizoram
- Nagaland
- Odisha
- Puducherry
- Punjab
- Rajasthan
- Sikkim
- Tamil Nadu
- Telangana
- Tripura
- Uttar Pradesh
- Uttrakhand
- West Bengal
- Medical Education
- Industry
Prolonged metformin treatment tied to more severe neuropathic pain in diabetics: Study
![Prolonged metformin treatment tied to more severe neuropathic pain in diabetics: Study Prolonged metformin treatment tied to more severe neuropathic pain in diabetics: Study](https://medicaldialogues.in/h-upload/2020/01/23/750x450_123468-diabetic-neuropathy.jpg)
Egypt: Diabetes patients treated with prolonged and higher doses of metformin are at a higher risk of more severe diabetic peripheral neuropathy (DPN) and lower cobalamin (vitamin B12), finds a recent study.
Diabetes mellitus (DM) is a chronic metabolic disease associated with high blood sugar owing to impaired insulin secretion, insulin activity, or both. High blood sugar levels can cause damage to all parts of the body including the cardiovascular system, eyes, kidneys, and nervous system in form of Metformin is first line treatment of diabetes.
The findings of the study, published in the journal Scientific Reports, suggest that diabetes patients treated with metformin should be monitored for serum methylmalonic acid, cobalamin, and homocysteine to mitigate DPN symptoms. Cobalamin is associated with various metabolic functions including intact nervous system and generation of RBCs, so its dysfunction can cause neurological impairment and anemia.
Metformin-treated diabetics (MTD) showed a decrease in cobalamin, a rise in methylmalonic acid, and homocysteine, leading to accentuated diabetic peripheral neuropathy. The study by Mohammed El-Sherif, Mansoura University, Mansoura, Dakahlia, Egypt, and colleagues aimed to determine whether or not metformin is a risk factor for diabetic peripheral neuropathy.
For the purpose, the researchers compared MTD to non-metformin-treated diabetics (NMTD) clinically using the Toronto Clinical Scoring System (TCSS), laboratory (methylmalonic acid, cobalamin, and homocysteine), and electrophysiological studies.
Key findings of the study include:
- Median homocysteine and methylmalonic acid levels in MTD vs. NMTD were 15.3 vs. 9.6 µmol/l and 0.25 vs. 0.13 µmol/l, respectively with high statistical significance in MTD.
- There was a significantly lower plasma level of cobalamin in MTD than NMTD.
- Spearman's correlation showed a significant negative correlation between cobalamin and increased dose of metformin and a significant positive correlation between TCSS and increased dose of metformin.
- Logistic regression analysis showed that MTD had significantly longer metformin use duration, higher metformin dose > 2 g, higher TCSS, lower plasma cobalamin, and significant higher homocysteine.
"Our findings suggest that diabetics treated with metformin for prolonged duration and higher doses were associated with lower cobalamin and more severe diabetic peripheral neuropathy.
MSc. Biotechnology
Medha Baranwal joined Medical Dialogues as an Editor in 2018 for Speciality Medical Dialogues. She covers several medical specialties including Cardiac Sciences, Dentistry, Diabetes and Endo, Diagnostics, ENT, Gastroenterology, Neurosciences, and Radiology. She has completed her Bachelors in Biomedical Sciences from DU and then pursued Masters in Biotechnology from Amity University. She has a working experience of 5 years in the field of medical research writing, scientific writing, content writing, and content management. She can be contacted at  editorial@medicaldialogues.in. Contact no. 011-43720751
Dr Kamal Kant Kohli-MBBS, DTCD- a chest specialist with more than 30 years of practice and a flair for writing clinical articles, Dr Kamal Kant Kohli joined Medical Dialogues as a Chief Editor of Medical News. Besides writing articles, as an editor, he proofreads and verifies all the medical content published on Medical Dialogues including those coming from journals, studies,medical conferences,guidelines etc. Email: editorial@medicaldialogues.in. Contact no. 011-43720751