Abstract

S. Aisha*, K. Sravani, G. Imran, R. Harsha Sree, Dr. K. Thirumala Naik and Dr. Jayabhaskar

ABSTRACT

Diabetes mellitus (DM) is a chronic metabolic disorder characterized by persistent hyperglycemia, resulting from defects in insulin secretion, insulin action, or a combination of both. DM is classified into type 1 DM (insulin-dependent), type 2 DM (non-insulin-dependent), gestational diabetes, and other forms such as MODY and LADA. Type 2 DM (T2DM), a major subtype, involves progressive β-cell dysfunction and insulin resistance, often linked to metabolic syndrome (MDS). Oral hypoglycemic agents (OHAs) are the cornerstone of T2DM management, with metformin being the first-line agent. Metformin works by inhibiting hepatic gluconeogenesis, effectively lowering blood glucose levels. Despite its benefits, prolonged use of metformin is associated with vitamin B12 deficiency, affecting up to 30% of users. Symptoms may mimic diabetic neuropathy and cause irreversible neurological damage if untreated. Regular screening and timely intervention are critical for prevention and management. Treatment includes parenteral or high-dose oral vitamin B12 supplementation, with studies showing comparable efficacy of both methods. Preventive measures, including annual serum B12 level monitoring, are essential for at-risk populations.