Plasma Homocystein, Folates and Vitamin B12 in Type 2 Diabetes Patients on Metformin Treatment

Issue: 4/2003

Abstract:

Hyperhomocysteinemia is considered to be an independent risk factor for CVD. The antidiabetic drug Metformin has been associated with hyperhomocysteinemia. The purpose of this study was to assess the effect of 6-month Metformin treatment on serum homocystein, folates and vitamin B₁₂ in type 2 diabetes patients. 18 patients participated – 9 males and 9 females, mean age was 47,6 and mean diabetes duration – 6,1 years. At baseline and after 6 months of treatment at a mean daily dose of 1500 mg Metformin, we measured serum levels of homocystein, folates and vitamin В , as well as indices of glycemic and lipid profile, and some anthropometric and biochemical parameters. Plasma homocystein did not change, whereas folates and vitamin B₁₂ were non-significantly reduced (folates dropped from 25,9 to 21,7 nmol/l, and vitamin B₁₂ – from 233,3 to 207,4 pmol/l). No changes were found in erythrocytes or serum iron. Glycaemic control improved (HbA_1c fell by 0,9%), total cholesterol dropped (by 0,8 mmol/l). A slight reduction was seen, both of body weight (by a mean of 3,2 kg) and waist/hip ratio (by 0,03). The metformin treatment has practically no impact on plasma homocystein and the latter can not compare with the great benefit concerning the risk of CVD. Metformin treatment does not require additional treatment with folates or other drugs.

Keywords: type 2 diabetes, metformin, homocystein, folates, vitamin B₁₂

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