Mahmood A Alawainati1, Zahra A Ayoob1, Huda S Naser1, Shatha Sarhan2, Zainab Ayoob3
Background and Objectives: Cobalamin, also known as vitamin B12, is essential for DNA synthesis and neurological functioning. Deficiency results in hematological and neurocognitive manifestations. One risk factor for vitamin B12 deficiency is the use of metformin, a common oral hypoglycemic agent. This study was conducted to determine cobalamin status in patients with type 2 diabetes mellitus at primary health care centers in Bahrain.
Methods: This cross-sectional study was conducted in five randomly selected health centers in Bahrain. Vitamin B12 levels below 148 pmol/L were categorized as deficient, levels ranging from 148 to 221 pmol/L were considered borderline, and levels exceeding 221 pmol/L were classified as normal.
Results: A total of 691 participants were included in the study, with a mean age of 58.7 years. The most common comorbid condition among our cohort was hypertension (63.1%), followed by dyslipidemia (53.1%). Analysis of the glycemic control showed that only 40% of the participants achieved control targets. Nearly 10% (9.4%, n=65) of the cohort had low levels of vitamin B12, and 31% had borderline values. A significant association was seen between low vitamin B12 levels and Bahraini nationality (P<0.001), and patients who engaged in weekly exercise (P=0.007). Furthermore, the analysis revealed that the use of metformin (P=0.037) and alcohol (P=0.012) was significantly associated with low levels of vitamin B12.
Conclusion: Although the overall prevalence of B12 deficiency among patients with type 2 diabetes in Bahrain was low, patients at high risk of B12 deficiency, including metformin users and alcohol consumers, should be periodically screened to prevent the associated neurological and hematological sequela.
Keywords: Bahrain, Cobalamin, Diabetes Mellitus, Primary Health Care, Vitamin B12