Assessment of the Effects of Metformin and DPP-4 Inhibitors on Electrolyte and Vitamin B12 Levels in Patients with Type 2 Diabetes: A Retrospective Study

Aim: Type 2 diabetes mellitus (T2DM) is commonly managed using metformin and DPP-4 inhibitors (vildagliptin, linagliptin) to improve glycemic control. However, their effects on electrolyte, mineral, and vitamin B12 levels remain unclear. The aim of this research was to evaluate the impact of metformin and DPP-4 inhibitors on electrolyte levels, as well as mineral and vitamin B12 levels. Material and Methods: Electrolyte and mineral levels (including sodium, potassium, calcium, magnesium, and chloride), along with vitamin B12 concentrations, measured through standard laboratory methods in blood samples from T2DM patients receiving metformin and DPP-4 inhibitors, as well as healthy controls, were retrospectively obtained from medical records. The results were analyzed by comparing the control group with the treatment groups and the treatment groups with each other. Results: Sodium levels were decreased significantly in the metformin+DPP-4 inhibitor group compared to the metformin group (p=0.034). Potassium concentrations were considerably elevated in both the metformin group and the DPP-4 inhibitor group than in the control group (p=0.010 and p=0.006, respectively). Vitamin B12 concentrations demonstrated a statistically significant reduction in the metformin+DPP-4 inhibitor group relative to the control group (p=0.006). Conclusion: These findings highlight the potential impact of metformin and DPP-4 inhibitors on mineral and electrolyte homeostasis, emphasizing the importance of regular assessment of electrolyte levels and vitamin B12 status in individuals receiving these treatments.