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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| Format: | Article |
| Language: | English |
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Nature Portfolio
2021-01-01
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| Series: | Scientific Reports |
| Online Access: | https://doi.org/10.1038/s41598-021-81631-8 |
| _version_ | 1818431125110915072 |
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| 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 |
| collection | DOAJ |
| 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. |
| first_indexed | 2024-12-14T15:44:20Z |
| format | Article |
| id | doaj.art-4f2eb751760e4a0dab4c6df1f3f332c1 |
| institution | Directory Open Access Journal |
| issn | 2045-2322 |
| language | English |
| last_indexed | 2024-12-14T15:44:20Z |
| publishDate | 2021-01-01 |
| publisher | Nature Portfolio |
| record_format | Article |
| series | Scientific Reports |
| spelling | doaj.art-4f2eb751760e4a0dab4c6df1f3f332c12022-12-21T22:55:32ZengNature PortfolioScientific Reports2045-23222021-01-011111910.1038/s41598-021-81631-8The relationship between exacerbated diabetic peripheral neuropathy and metformin treatment in type 2 diabetes mellitusManal Mohammed Hashem0Ahmed Esmael1Abdelfattah Kasem Nassar2Mohammed El-Sherif3Internal Medicine Department, Faculty of Medicine, Zagazig UniversityNeurology Department, Mansoura Faculty of Medicine, Mansoura UniversityRheumatology Department, Physical Medicine and Rehabilitation Faculty of Medicine, Al-Azhar UniversityNeurology Department, Mansoura Faculty of Medicine, Mansoura UniversityAbstract 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.https://doi.org/10.1038/s41598-021-81631-8 |
| spellingShingle | 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 Scientific Reports |
| title | 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_short | 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 |
| url | https://doi.org/10.1038/s41598-021-81631-8 |
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