Some background first. I am 41, Male, Indian. Vegetarian (eggs occasionally), alcohol 3-4 times a year, non-smoker, refrain from junk food, sodas & fruit juices. BMI of 22, though not athletic.
I was diagnosed with Vit B12 deficiency around 2010 - level was around 96 or so. I was given 1000 mcg orally. After about 2 months the level did not rise significantly so I was asked to take injections. I delayed and took injections in early 2012. The dosage was daily for a week, weekly for a month, and monthly 2 months. The B12 level increased at that time.
Now to 7 March 2014. I went for a routine health checkup (complete blood count, lipid profile, fasting blood sugar, liver function test, HBA1c, EKG), & also B12 test. B12 level came to 122 pg/ml (normal marked is 180-914). So evidently I am deficient in B12. And my symptoms of tiredness, lack of focus, disturbed sleep, etc. are back.
In the Lipid profile, Total Cholesterol, Tryglycerides, HDL, VLDL and Cholesterol to HDL ratio are all within the mentioned normal range, but LDL is 116 with a normal range mentioned of “<100″.
Liver function test parameters are all mentioned within normal range.
But yesterday for the first time my Fasting Blood Sugar (FBS) was above the normal level 133 mg/dL (normal mentioned as 70-100) with HBA1c at 6.7%. On 08-Mar I went to another lab and repeated both tests. FBS was 108 while HBA1c is still showing as 6.7%. The last time I did a health checkup was in Jan 2012. Fasting was 90 and HBA1c was 5.7%.
The doctor whom I met on 07-Mar was seeing me for the first time. He has prescribed Metformin 500mg once daily, telling me that I have Type 2 Diabetes.
The questions I have are:
1. Is it the B-12 deficiency & not diabetes that is causing high HBA1C?
2. Given B12 deficiency, should I start Metformin (I have read that it can cause severe B12 deficiency), or should I first try with diet control, exercise and a repeat course of B12 injections?
Thanks in advance.