AN OBSERVATIONAL STUDY OF PERIPHERAL NEUROPATHY IN DIABETES PATIENTS ON METFORMIN THERAPY AND THE ROLE OF VITAMIN B-12 SUPPLEMENTATION

Objective: This study aims to assess the prevalence of peripheral neuropathy in diabetic patients on metformin therapy using the Douleur Neuropathique 4 (DN-4) scale, explore the relationship between long-term metformin use and serum vitamin B-12 levels, and identify how metformin contributes to neuropathy. Additionally, it seeks to raise awareness about the importance of vitamin B-12 monitoring and supplementation for improving patient quality of life. Methods: An observational study was conducted involving diabetes patients on metformin therapy. Data were collected on patient demographics, clinical characteristics, and vitamin B-12 levels. Peripheral neuropathy was assessed using the DN-4 questionnaire. Correlations between metformin duration, dosage, vitamin B-12 levels, and neuropathy prevalence were analyzed. Results: The results indicated that the majority of the study population were male (61.2%) and aged 51-60 years (41.8%), with a majority proportion residing in urban areas (74%). A significant finding was that Peripheral neuropathy was prevalent in 44.8% of patients, with 51.5% exhibiting vitamin B-12 deficiency. Furthermore, the study identified a high prevalence of peripheral neuropathy with a significant correlation between longer metformin use and increased neuropathy (r =0.9372), additionally, a strong negative correlation between metformin dosage and Vitamin B-12 levels (r=-0.9189) highlighted the risk of deficiency with higher doses. Conclusion: The study underscores the critical role of monitoring and supplementing vitamin B-12 in diabetes patients on metformin therapy to mitigate peripheral neuropathy. Regular screening and proactive supplementation could potentially reduce neuropathic complications associated with long-term metformin use.