Is vitamin B12 testing in diabetics overmedical? Expert tips to be wary of the lack of VB12
In addition to outpatient visits and ward rounds, the work in the department is to cultivate as many backbones as possible for the department. In our experience, the more doctors who like to ask questions, the faster they grow. No, a young doctor who had just entered the department came to ask, saying that it was the patient he was in charge of, and he had doubts about the cost when he was discharged from the hospital.
"I'm here to adjust my blood sugar. Why are you testing me for vitamin B12 and folic acid? Did you take the opportunity to charge me more for the test?"
The little doctor couldn't answer for a while, so he came to ask me.
Many friends who are hospitalized for diabetes may also ask, why do you want to check these? Today, let’s talk about why doctors check vitamin B12 levels in diabetic patients.
Healthy people rarely have vitamin deficiencies
B12
Insufficient intake or malabsorption of vitamin B12 can lead to anemia, nutrient deficiency diseases of nervous system and skin and mucous membrane damage. therefore,
B12 is very important for the human body. It may be because the human body is afraid of lack of B12 and has a sense of crisis in advance. The human body usually stores a large amount of vitamin B12. It takes 3 years to consume all the vitamin B12 accumulated in the body, and 5 years after the vitamin B12 accumulated in the body is completely consumed, the deficiency will appear.
Therefore, healthy people are usually not easily deficient in vitamin B12. Therefore, it is no wonder that most people suspect that it is excessive medical treatment when they see that there is a test for vitamin B12 in the test.
Vitamin B12 is very important for people with diabetes
Vitamin B12 helps protect nerves. Diabetic hyperglycemia can easily lead to microvascular circulation disorders, leading to peripheral nerve dysfunction, thereby causing diabetic peripheral neuropathy. Manifested as numbness, crawling sensation, decreased pain and temperature sensation, etc. Vitamin B12 has the function of maintaining nerve myelin, which can prevent and treat peripheral neuritis caused by diabetes.
Vascular disease is one of the most common complications of diabetes. Studies have found that high homocysteine levels in diabetic patients are closely related to diabetic vascular disease, which can lead to diabetic nephropathy, cerebrovascular sclerosis, coronary atherosclerosis, and diabetic retinopathy. However, serum homocysteine levels in diabetic patients are negatively correlated with vitamin B12 levels. Vitamin B12 can promote the metabolism of homocysteine and accelerate its clearance. Vitamin B12 supplementation can prevent and delay diabetic vascular disease.
Therefore, we recommend that friends with diabetes, especially elderly friends, should supplement vitamin B12 daily. Of course, checking your vitamin B12 levels can also do the trick.
Why are diabetic friends deficient in vitamin B12?
Let's take a look at why people with diabetes are prone to vitamin B12 deficiency.
Metformin is a commonly used drug for the treatment of type 2 diabetes. Metformin is designated as a first-line drug in several diabetes management guidelines. However, a side effect of metformin is that it reduces the level of vitamin B12 in the body, so long-term use may cause vitamin B12 deficiency.
Elderly diabetics are prone to vitamin B12 deficiency. Most of the patients with diabetes are the elderly. As the age increases, the function of each organ gradually declines, so the gastrointestinal function of the elderly also declines, the metabolism slows down, the food intake is too small, and they are worried about the intake of fat and cholesterol. They are unwilling to eat animal offal and egg yolk, and eat less lean meat, so it is easy to cause various nutritional deficiencies, including vitamin B12.
Diet therapy is the most basic treatment for diabetes control. Diabetics need to control energy intake to prevent high blood sugar, especially meat intake, which may lead to insufficient intake of vitamin B12, resulting in nutritional deficiencies. It can even cause megaloblastic anemia.
Then we know that people with diabetes are prone to lack of vitamin B12, and then we will understand how we know that the body lacks it.
What are the symptoms of vitamin B12 deficiency?
Patients with skin manifestations may have extensive and symmetrical pigmentation, especially in the curved parts of the body, palms, soles, nails and oral cavity. Hair turns gray, and finger/toenails may be hyperpigmented.
Pernicious anemia due to lack of vitamin B12 caused by megaloblastic anemia. Severe anemia can cause fatigue, difficulty breathing, and symptoms associated with congestive heart failure,
Vitiligo
and
Alopecia areata
。
Digestive tract symptoms Nausea, vomiting, heartburn, bloating and gas, constipation or diarrhea, loss of appetite and weight loss, etc.
Heart symptoms Vitamins B9, B6, and B12 can also control the level of homocysteine in the blood, and an increase in homocysteine can lead to heart disease.
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The symptoms of the system appear later, with or without anemia, there may be neurological disorders, spinal cord degeneration, demyelination and severe neurological symptoms, and even dementia, coma and death. Diabetic patients are prone to complications of neurological disease, showing facial nerve pain, or nerve pain in other parts, numbness and pain in hands and feet, tingling, etc.
- Decreased vision
Without enough vitamin B12 for a long time, it will accelerate the rate of retinopathy in diabetic patients and cause damage to the capillaries around the eye.
I would like to remind friends who have the above symptoms, whether they have diabetes or not, they need to go to the hospital to test the B12 content.
**## how to supplement vitamin b12
There are both in and out, and there is a balance. There are two main aspects of supplementing vitamin B12.
1. It is mainly a dietary supplement. The main foods for vitamin B12 are animal liver and kidney, pork, mutton, chicken, beef, clams, eggs, duck eggs, quail eggs, fish, milk, cheese, dairy products, fermented bean curd, etc. Diabetic friends can achieve nutritional balance and eat appropriately.
2. B12 preparations are supplementary supplements. If you have other symptoms, please consult a doctor or a nutritionist.
Tip: If a vitamin B12 deficiency is diagnosed, vitamin B12 can be administered intramuscularly or by mouth
B12
Treatment, along with dietary supplements, can improve symptoms. vitamin supplement
B12
At the same time, attention should be paid to potassium supplementation to prevent the occurrence of
Hypokalemia
。
These are the recommendations for people with diabetes to pay attention to vitamin B12 supplementation. You are welcome to leave your questions in the comments below, and I will try my best to answer them. See you next time.**