When to start screening for B12 deficiency in your diabetes patients taking metformin? We review a dose-response diet study plus 2 others on oral drugs.
Study 1. Metformin Association with Vitamin B12 Deficiency in Type 2 Diabetes (T2D) Patients: Dose-Response and Diet Assessment Study.
Study 1. B12 deficiency related to dose and duration of metformin was not adequately compensated by dietary intake.
Study 1. Conclusion: A targeted screening for B12 deficiency is warranted in patients taking metformin in dose of more than 2,000mg/day over a period of more than 4 years. Link to Abstract.
Study 2. Comparison between Adherence to Glimepiride/Metformin Sustained Release Once-Daily vs Immediate-Release Twice-Daily Fixed Combination Therapy in Patient with Type 2 Diabetes Using an Electronic Medication Events Monitoring System: Randomized Controlled Study
Study 2. Adherence with once-daily, sustained-release (SR) oral antidiabetic and twice-daily immediate-release (IR) was compared using an electronic medication events monitoring system.
Study 2. Conclusion: Patient adherence with their antidiabetic regimen is a primary factor in optimal long-term treatment; adherence with the simpler once-daily dosing of a sustained-release combination agent was found to be significantly better than with twice daily immediate release. Link to Abstract.
Clinical Efficacy and Safety of Fixed-Dose Combination of Glimepiride and Metformin in Patients with Type 2 Diabetes Inadequately Controlled by Each Component Alone or Used as Free Combo
With the previous report of greater adherence to once-daily SR oral antidiabetic agents than with twice-daily IR agents, this study evaluates efficacy and safety of the fixed combination after inadequate control on each component alone or in free combination.
During the general poster sessions at the American Diabetes Association (ADA) 77th Scientific Sessions, several of the work-horse oral antihyperglycemic agents were highlighted in studies that looked at B12 deficiency with metformin therapy; adherence with different glimepiride regimens as assessed by an electronic monitoring system; and, the efficacy of a fixed-dose combination vs that of the individual components.