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Diabetes of B12 Deficiency

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.
2 Responses
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Avatar universal
Thank you very much for your response.  It definitely helps.  I watched carbs and sugar for a week and got myself tested again yesterday, though at a different lab this time.  Fasting showed up as 90 and PPBS (2 hours after breakfast consisting of cracked wheat and a cup of tea containing milk) showed up as 109.  I didn't get the A1C test done because it's probably too soon.  I am meeting another physician this Monday - a senior doctor recommended by a few people I know.  I will definitely mention all of the above to him.  I'll post again about what he says.
Helpful - 0
5289563 tn?1366048434
MEDICAL PROFESSIONAL
Thanks for using the forum.

There are some drugs and supplements that can effect A1C results. Vit. B12 is one of those. It can cause elevated results on the A1C. Your A1c level is elevated, but it is in a caution area. In your circumstance I might get a second opinion before starting medications.

According to the information you have provided, you are already watching your diet. In my reading about Vit. B12 deficiency and A1C, I did come across the fact that vegetarians and vegans are more likely to suffer from Vit. B12 deficiency. This is because the only foods that deliver Vit B12 naturally are  meat, eggs, poultry, dairy products, and other foods from animals. If you are not ingesting grains fortified with Vit. B12 or supplemental Vit. B12 you have no source for the vitamin.

I recommend that if possible, you see an endocrinologist. They can help you evaluate your A1C results. Make sure to ask about relationship with HA1C and Vit B12. It may be that you will need to start medication, but ask about diet and lifestyle modifications. A nutritionist or dietician might also be helpful in managing your diet to make sure you are getting foods supplemented with Vit. B12 and also managing your blood sugar.

I hope this helps.

Cathy
Helpful - 0

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