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Current Diabetes Reviews

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ISSN (Print): 1573-3998
ISSN (Online): 1875-6417

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Research Article

Physicians’ Perception About Use of Vitamin B12 in the Treatment or Prevention of Diabetic Neuropathy: A Cross-sectional Survey in Saudi Arabia

Author(s): Khaled K. Aldossari*, Sameer Al-Ghamdi, Jamaan Alzahrani, Maram S. Al Turki , Mai Almuhareb, Ziad G. Alanazi , Ziyad M. Alshahrani and Jencia Wong

Volume 18, Issue 2, 2022

Published on: 11 February, 2021

Article ID: e021021191310 Pages: 10

DOI: 10.2174/1573399817666210211095610

Abstract

Background: Diabetic neuropathy is a condition that is prevalent among type 2 diabetic patients. Some physicians prescribe vitamin B12 or vitamin B complex supplements to improve symptoms, but studies have shown that there is little to no evidence of vitamin B12 being an effective treatment for diabetic neuropathy. Thus, this study aims to investigate local physicians’ knowledge and tendency to prescribe vitamin B12 or vitamin B complex for the treatment or prevention of diabetic peripheral neuropathy.

Methods: It was a cross-sectional study, conducted between May and November of 2019, in several primary healthcare centers in different cities of Saudi Arabia. A total of 412 physicians with a minimum of three years of experience answered a three-part questionnaire on their demographic information, prescribing behavior, and knowledge of the relationship between vitamin B12 or vitamin B complex and diabetic neuropathy.

Results: The study found that only 42% of the physicians believed that vitamin B12 supplementation did not prevent diabetic neuropathy, while only 52.7% found it to be an ineffective treatment for this condition. Moreover, 58.7% stated that they had certainly prescribed vitamin B12 or multivitamins as a form of treatment or prevention of diabetic neuropathy. 47.8% of the patients requested a vitamin B12 prescription 1-6 times from their physicians, while 31.6% of them requested it ≥ 7 times, with 42.5% of physicians agreeing that their prescriptions of vitamin B12 had been a result of patient demand more than clinical justification. Likewise, 43% of respondents were aware that vitamin B12 levels should be tested annually. Furthermore, a higher proportion of consultants chose not to prescribe vitamin B12 to prevent or treat diabetic neuropathy than any other rank.

Conclusion: The findings of this study indicate a tendency of unnecessarily prescribing vitamin B12 supplementation for the prevention or treatment of diabetic neuropathy as well as a lack of knowledge on the matter among doctors in primary care hospitals in Saudi Arabia. The study has also shown that there are patients who often request this prescription, adding pressure on their physicians to comply. Future studies should investigate most of the hospitals in Saudi cities and include less experienced residents and medical students.

Keywords: Diabetic neuropathy, primary care physicians, vitamin B12, cross-sectional study, supplementation, cobalamin.

[1]
Zeuschner CL, Hokin BD, Marsh KA, Saunders AV, Reid MA, Ramsay MR. Vitamin B12 and vegetarian diets. Med J Aust 2013; 199(S4): S27-32.
[PMID: 25369926]
[2]
Carmel R. How I treat cobalamin (vitamin B12) deficiency. Blood 2008; 112(6): 2214-21.
[PMID: 18606874]
[3]
Shipton MJ, Thachil J. Vitamin B12 deficiency - A 21st century perspective. Clin Med (Lond) 2015; 15(2): 145-50.
[PMID: 25824066]
[4]
Dali-Youcef N, Andrès E. An update on cobalamin deficiency in adults. QJM 2009; 102(1): 17-28.
[PMID: 18990719]
[5]
Khanra R, Dewanjee S, K Dua T, et al. Abroma augusta L. (Malvaceae) leaf extract attenuates diabetes induced nephropathy and cardiomyopathy via inhibition of oxidative stress and inflammatory response. J Transl Med 2015; 13(1): 6.
[PMID: 25591455]
[6]
Dewanjee S, Das S, Das AK, et al. Molecular mechanism of diabetic neuropathy and its pharmacotherapeutic targets. Eur J Pharmacol 2018; 833: 472-523.
[PMID: 29966615]
[7]
Hilsted J, Low PA. Diabetic Autonomic Neuropathy. Philadelphia: Lippincott-Raven Publishers 1997.
[8]
Veves A, King GL. Can VEGF reverse diabetic neuropathy in human subjects? J Clin Invest 2001; 107(10): 1215-8.
[PMID: 11375408]
[9]
Freeman R. Diabetic autonomic neuropathy. In: Handb Clin Neurol. 2014; 126: pp. 63-79.
[10]
Algeffari MA. Painful Diabetic peripheral neuropathy among Saudi diabetic patients is common but under-recognized: Multicenter cross-sectional study at primary health care setting. J Family Community Med 2018; 25(1): 43-7.
[PMID: 29386961]
[11]
Sendi RA, Mahrus AM, Saeed RM, Mohammed MA, Al-Dubai SAR. Diabetic peripheral neuropathy among Saudi diabetic patients: A multicenter cross-sectional study at primary health care setting. J Family Med Prim Care 2020; 9(1): 197-201.
[PMID: 32110590]
[12]
Franklin GM, Kahn LB, Baxter J, Marshall JA, Hamman RF. Sensory neuropathy in non-insulin-dependent diabetes mellitus. The San Luis Valley Diabetes Study. Am J Epidemiol 1990; 131(4): 633-43.
[PMID: 2316495]
[13]
Ziegler D, Rathmann W, Dickhaus T, Meisinger C, Mielck A. Neuropathic pain in diabetes, prediabetes and normal glucose tolerance: The MONICA/KORA Augsburg Surveys S2 and S3. Pain Med 2009; 10(2): 393-400.
[PMID: 19207236]
[14]
Lee CC, Perkins BA, Kayaniyil S, et al. Peripheral neuropathy and nerve dysfunction in individuals at high risk for type 2 diabetes: The PROMISE cohort. Diabetes Care 2015; 38(5): 793-800.
[PMID: 25665810]
[15]
Abbott CA, Malik RA, van Ross ERE, Kulkarni J, Boulton AJM. Prevalence and characteristics of painful diabetic neuropathy in a large community-based diabetic population in the U.K. Diabetes Care 2011; 34(10): 2220-4.
[PMID: 21852677]
[16]
Iqbal Z, Azmi S, Yadav R, et al. Diabetic peripheral neuropathy: Epidemiology, diagnosis, and pharmacotherapy. Clin Ther 2018; 40(6): 828-49.
[PMID: 29709457]
[17]
Vollert J, Maier C, Attal N, et al. Stratifying patients with peripheral neuropathic pain based on sensory profiles: Algorithm and sample size recommendations. Pain 2017; 158(8): 1446-55.
[PMID: 28595241]
[18]
Snyder MJ, Gibbs LM, Lindsay TJ. Treating painful diabetic peripheral neuropathy: An update. Am Fam Physician 2016; 94(3): 227-34.
[PMID: 27479625]
[19]
Jayabalan B, Low LL. Vitamin B supplementation for diabetic peripheral neuropathy. Singapore Med J 2016; 57(2): 55-9.
[PMID: 26892473]
[20]
Alvarez M, Sierra OR, Saavedra G, Moreno S. Vitamin B12 deficiency and diabetic neuropathy in patients taking metformin: A cross-sectional study. Endocr Connect 2019; 8(10): 1324-9.
[PMID: 31518991]
[21]
Yang W, Cai X, Wu H, Ji L. Associations between metformin use and vitamin B12 levels, anemia, and neuropathy in patients with diabetes: a meta-analysis. J Diabetes 2019; 11(9): 729-43.
[PMID: 30615306]
[22]
Russo GT, Giandalia A, Romeo EL, et al. Diabetic neuropathy is not associated with homocysteine, folate, vitamin B12 levels, and MTHFR C677T mutation in type 2 diabetic outpatients taking metformin. J Endocrinol Invest 2016; 39(3): 305-14.
[PMID: 26233336]
[23]
Page N, DeLuca JP, Crowell K. What medications are best for diabetic neuropathic pain? 2012.
[24]
Sun Y, Lai M-S, Lu C-J. Effectiveness of vitamin B12 on diabetic neuropathy: systematic review of clinical controlled trials. Acta Neurol Taiwan 2005; 14(2): 48-54.
[PMID: 16008162]
[25]
Cham G, Davis N, Strivens E, Traves A, Manypeney G, Gunnarsson R. Factors correlating to the propensity of general practitioners to substitute borderline vitamin B12 deficiency. Scand J Prim Health Care 2018; 36(3): 242-8.
[PMID: 29933709]

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