Metformin, a commonly prescribed hypoglycemic agent is a first line medication for the management of Type 2 diabetes mellitus. Numerous studies have depicted that metformin therapy has been associated with vitamin B12 and folate deficiency. Vitamin B12 deficiency is frequently missed or misdiagnosed by the clinicians because it is not routinely tested by most of the physicians, further the low end of the laboratory reference range is too low and misinterpreted as diabetic peripheral neuropathy. Vitamin B12 deficiency is a silent epidemic with serious consequences. Long term use of metformin has been associated with increased homocysteine levels and malabsorption of vitamin B12 leading to its deficiency and neurological manifestations. Polymorphisms of certain genes associated with the metabolism of vitamin B12 and folate might help in predicting the deficiency status of vitamin B12.Asian Journal of Medical Sciences Vol.9(1) 2018 11-14

Background: B12 deficiency is a silent epidemic with serious consequences. Long term use of metformin has been associated with malabsorption of vitamin B12 leading to its deficiency along with increased homocysteine levels. With this background we designed this study to assess the status of vitamin B12 and its markers in type 2 diabetes mellitus patients on metformin therapy who are attending tertiary care hospital in the peripheral area of Pondicherry.Aims and Objective: The current study aims to study the relationship if any, between the glycemic status and the status of Vitamin B12 among T2DM patients on metformin therapy.Materials and Methods: A case control study was done with a sample size of 100 (50 case and 50 control). The patients were selected according to the inclusion criteria and their blood sample were analyzed for the various parameters. The markers of vitamin B12 status are studied among both the control and the patients with T2DM on metformin therapy and compared with their glycaemic status.Results: There is a significant increase in the levels of FBS, HbA1c, insulin and C-peptide in the study group. It was observed that the mean levels of homocysteine and Methylmalonic acid were significantly higher with lower levels of vitamin B12 in patients who were on metformin therapy.Conclusion: There is moderate correlation between the markers of B12 status and levels of fasting blood sugar as well as HbA1C. There is a significant correlation between insulin and C-peptide with the markers of vitamin B12 status.Asian Journal of Medical Sciences Vol.9(2) 2018 9-12

Vitamin D nemesis of COVID-19 - IJCBR- Print ISSN No: - 2394-6369 Online ISSN No:- 2394-6377 Article DOI No:- 10.18231/j.ijcbr.2021.038, International Journal of Clinical Biochemistry and Research-Int J Clin Biochem Res

The Geriatric Nutritional Risk Index (GNRI) is a promising tool for predicting nutrition-related issues in sub-acute care settings. The primary goal of this study was to verify the application of GNRI in elderly hospitalized patients by evaluating its predictive power of patient outcome using a comparison with the nutritional assessment and frequency of dialysis.: To study the surveillance in geriatric patients on maintenance of hemodialysis and to collect the demographic and blood sample from the patient, evaluate the blood sample using various technique. To assess the relationship between GNRI, dialysis frequency and adequacy.: It is a multi-speciality hospital -based cohort study. We enrolled patients, aged between 60-85 years undergoing maintenance hemodialysis patients were followed thrice a week .Nutritional risk index was assessed by the Geriatric Nutritional Risk Index (GNRI) adequacy of dialysis was calculated using Daugirdas dialyzer clearance of urea (Kt/V) method. The study population comprised 54 geriatric dialysis patients ranging from 60-85 years of age.57% of the chosen patient population had both diabetes mellitus and hypertension as co-morbid conditions. In contrast, 17% of the patients had only hypertension. 9% had only diabetes mellitus Rest of the patients presented with diabetes mellitus, hypertension, polycystic kidney disease and diabetic kidney disease as co-morbidities. Among these patients, 40% underwent twice-weekly dialysis and the remaining 60% underwent thrice-weekly dialysis.12% of these 54 patients were categorized as high risk on the GNRI, 9% as moderate risk and 22% of the patients were low risk. 57% of the patients were devoid of any risk on the GNRI. 43% of the study population fell in the normal BMI range between 18.5-24.9, whereas 33% were found to be overweight with their BMI ranging between 25-29.9, While 13% of the subjects were classified as being underweight with a BMI below 18.5,11% the patients were found to be obese (category4).The observations from the current study indicate that more frequent and adequate dialysis likely enhances the standard of living and lowers the GNRI risk in elderly dialysis patients.