Therefore , although the overall effect of metformin on the concentration of serum Hcy was neutral , our results suggested that metformin could increase the concentration of Hcy when exogenous B-group vitamins or folic acid supplementation was not given
The aim of this systematic review is to assess whether metformin could change the concentration of serum homocysteine ( Hcy ) with and without simultaneous supplementation of B-group vitamins or folic acid .
Effects of short-term treatment with metformin on serum concentrations of homocysteine, folate and vitamin B12 in type 2 diabetes mellitus: a randomized, placebo-controlled trial.
OBJECTIVE Metformin is a key treatment option in type 2 diabetes . However , metformin may decrease vitamin B12 levels and increase levels of homocysteine , a cardiovascular risk factor . We investigated whether 16 weeks of treatment with metformin affects serum concentrations of homocysteine , folate and vitamin B12 in subjects with type 2 diabetes treated with insulin . DESIGN Placebo-controlled , r and omized trial . MEASUREMENTS at baseline and 16 weeks later . SETTING This trial was conducted in the outpatient clinics of three general hospitals in The Netherl and s. SUBJECTS A total of 745 patients with type 2 diabetes , treated with insulin and not known with a contraindication for the use of metformin , were approached ; 390 gave informed consent and entered the study . Thirty-seven subjects dropped out ( 12 placebo and 25 metformin users ) . INTERVENTION Addition of metformin or placebo to insulin therapy . PRIMARY OUTCOME PARAMETERS : Serum homocysteine , folate , vitamin B12 , indices of glycaemic control and body weight . RESULTS Amongst those who completed 16 weeks of treatment , metformin use , as compared with placebo , was associated with an increase in homocysteine of 4 % ( 0.2 to 8 ; P=0.039 ) and with decreases in folate [ -7 % ( -1.4 to -13 ) ; P=0.024 ] and vitamin B12 [ -14 % ( -4.2 to -24 ) ; P<0.0001 ] . In addition , the increase in homocysteine could be explained by the decreases in folate and vitamin B12 . CONCLUSION In patients with type 2 diabetes , 16 weeks of treatment with metformin reduces levels of folate and vitamin B12 , which results in a modest increase in homocysteine . The clinical significance of these findings remains to be investigated
Therefore , although the overall effect of metformin on the concentration of serum Hcy was neutral , our results suggested that metformin could increase the concentration of Hcy when exogenous B-group vitamins or folic acid supplementation was not given
The aim of this systematic review is to assess whether metformin could change the concentration of serum homocysteine ( Hcy ) with and without simultaneous supplementation of B-group vitamins or folic acid .