The relationship between exacerbated diabetic peripheral neuropathy and metformin treatment in type 2 diabetes mellitus

Abstract Metformin-treated diabetics (MTD) showed a decrease in cobalamin, a rise in homocysteine, and methylmalonic acid, leading to accentuated diabetic peripheral neuropathy (DPN). This study aimed to determine whether or not metformin is a risk factor for DPN. We compared MTD to non-metformin-tr...

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Autores principales:	Manal Mohammed Hashem, Ahmed Esmael, Abdelfattah Kasem Nassar, Mohammed El-Sherif
Formato:	article
Lenguaje:	EN
Publicado:	Nature Portfolio 2021
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/4f2eb751760e4a0dab4c6df1f3f332c1
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spelling	oai:doaj.org-article:4f2eb751760e4a0dab4c6df1f3f332c12021-12-02T10:49:16ZThe relationship between exacerbated diabetic peripheral neuropathy and metformin treatment in type 2 diabetes mellitus10.1038/s41598-021-81631-82045-2322https://doaj.org/article/4f2eb751760e4a0dab4c6df1f3f332c12021-01-01T00:00:00Zhttps://doi.org/10.1038/s41598-021-81631-8https://doaj.org/toc/2045-2322Abstract Metformin-treated diabetics (MTD) showed a decrease in cobalamin, a rise in homocysteine, and methylmalonic acid, leading to accentuated diabetic peripheral neuropathy (DPN). This study aimed to determine whether or not metformin is a risk factor for DPN. We 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. Median homocysteine and methylmalonic acid levels in MTD vs. NMTD were 15.3 vs. 9.6 µmol/l; P < 0.001 and 0.25 vs. 0.13 µmol/l; P = 0.02, 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. Diabetics treated with metformin for prolonged duration and higher doses were associated with lower cobalamin and more severe DPN.Manal Mohammed HashemAhmed EsmaelAbdelfattah Kasem NassarMohammed El-SherifNature PortfolioarticleMedicineRScienceQENScientific Reports, Vol 11, Iss 1, Pp 1-9 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Manal Mohammed Hashem Ahmed Esmael Abdelfattah Kasem Nassar Mohammed El-Sherif The relationship between exacerbated diabetic peripheral neuropathy and metformin treatment in type 2 diabetes mellitus
description	Abstract Metformin-treated diabetics (MTD) showed a decrease in cobalamin, a rise in homocysteine, and methylmalonic acid, leading to accentuated diabetic peripheral neuropathy (DPN). This study aimed to determine whether or not metformin is a risk factor for DPN. We 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. Median homocysteine and methylmalonic acid levels in MTD vs. NMTD were 15.3 vs. 9.6 µmol/l; P < 0.001 and 0.25 vs. 0.13 µmol/l; P = 0.02, 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. Diabetics treated with metformin for prolonged duration and higher doses were associated with lower cobalamin and more severe DPN.
format	article
author	Manal Mohammed Hashem Ahmed Esmael Abdelfattah Kasem Nassar Mohammed El-Sherif
author_facet	Manal Mohammed Hashem Ahmed Esmael Abdelfattah Kasem Nassar Mohammed El-Sherif
author_sort	Manal Mohammed Hashem
title	The relationship between exacerbated diabetic peripheral neuropathy and metformin treatment in type 2 diabetes mellitus
title_short	The relationship between exacerbated diabetic peripheral neuropathy and metformin treatment in type 2 diabetes mellitus
title_full	The relationship between exacerbated diabetic peripheral neuropathy and metformin treatment in type 2 diabetes mellitus
title_fullStr	The relationship between exacerbated diabetic peripheral neuropathy and metformin treatment in type 2 diabetes mellitus
title_full_unstemmed	The relationship between exacerbated diabetic peripheral neuropathy and metformin treatment in type 2 diabetes mellitus
title_sort	relationship between exacerbated diabetic peripheral neuropathy and metformin treatment in type 2 diabetes mellitus
publisher	Nature Portfolio
publishDate	2021
url	https://doaj.org/article/4f2eb751760e4a0dab4c6df1f3f332c1
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The relationship between exacerbated diabetic peripheral neuropathy and metformin treatment in type 2 diabetes mellitus

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