SUN-610 Vitamin B12 deficiency in Patients on Long Term Metformin Therapy: A retrospective study in a New York City Hospital

Abstract Disclosure: A.E. De Rosairo: None. D. Patel: None. P. Charpuria: None. D.H. Sacoto: None. T. Rave: None. S. Tariq: None. R. Belokovskaya: None. A.A. Franco Akel: None. Background: Metformin is a widely used first-line antidiabetic medication. Several studies have shown an association between long-term metformin use and vitamin B12 deficiency. Currently, there are no clearly established screening guidelines for asymptomatic patients on chronic metformin therapy. Objective: We aimed to assess the current standard of practice and identify care gaps in screening for vitamin B12 deficiency in patients with diagnosis of Diabetes Mellitus type 2 (DMT2) on long-term metformin therapy. These results will serve to determine our benchmark to conduct a quality improvement project. Methods: We performed a retrospective review of medical records to identify patients between 18 and 85 years of age with DMT2 diagnosis on metformin therapy for at least one year, who were followed in the primary care clinic in January 2024, at Metropolitan Hospital, New York. Patients with a history of bariatric surgery, celiac disease, pre-diabetes, inflammatory bowel disease, or pernicious anemia were excluded. Data on the frequency of vitamin B12 screening and results were collected and analyzed using descriptive statistics. Results: 621 patients were on metformin, and 234 (37.7%) were screened for vitamin B12 deficiency. 4 patients (1.7%) were found to be deficient (below 232 pg/mL) and 20 patients (8.5%) had levels between 232 -333 pg/mL. In 46% of patients, a Vitamin B12 level was obtained to investigate anemia, neuropathy, and memory impairment. Discussion: The prevalence of vitamin B12 deficiency in metformin users ranges from 3% to 30%. Additionally, a study in Michigan involving over 13,000 patients, found that only 44.9% were screened, and 3.3% were found to be vitamin B12 deficient. Similarly, our data revealed low screening rates (37.7%), with 1.7 % of patients found to be deficient. Moreover, in our review almost half of the patients with DMT2 on metformin who had a vitamin B12 level obtained, this was aimed to investigate secondary causes of anemia, neuropathy, and memory impairment. Since this is an easily correctable side effect of a commonly used medication, increasing awareness among healthcare professionals can lead to early identification, to avoid complications. Presentation: Sunday, July 13, 2025