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    One of the most common and beneficial T2DM drugs may contribute to neuropathy and vitamin deficiency The link between metformin and vitamin B12 lowering is well-known and mentioned in American Diabetes Association guidelines as a disadvantage of the drug. However, there are no recommendations for monitoring and prevention of vitamin B12 deficiency for patients taking metformin. Vitamin B12 deficiency is associated with adverse effects such as fatigue, mental status changes, and neuropathy. Given the prevalence of neuropathy in diabetic patients, metformin-induced vitamin B12 deficiency is clinically relevant. The relationship between vitamin B12 deficiency and metformin was studied in a recent randomized placebo-controlled trial. The trial lasted 52 months and included 390 type 2 diabetes patients. They were treated with 850 mg metformin at doses up to three times a day or placebo. Link Between Metformin and Neuropathy, Glimepiride - Diabetes Type 2 - Medication - Metformin, Glimepiride. - YouTube
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