The role of folate and vitamin B12 serum levels of homocysteine in diabetic patients treated with metformin

Introduction: Diabetes has so many complications. Metformin is widely used in diabetics that have complications like reduction of Vit B12 and increasing the homocysteine. High levels of homocysteine can be a risk factor for cardiovascular disorders. Complementary therapy with folic acid can prevent homocysteine increament. Also this medicine can increase the vit B12. Method and Method:A total of45 patients with typeâ idiabetes that were on metformin devided into two groups : Folic acid & Placebo. 24patients received 1mg folic acid per day for three months and 21 patients as a witness received placebo. This patients intered in the study if had GFR> 60 . We checked CBC, Vit B12 , Homocysteine & Biochemistary at the base and after treatment the levels of Homocysteine, Vit B12 and CBC were checked again and the drug effects were examined. Results: In folic acid group Homocysteine decreased from 12.8 to12.4 (P = - 0.6)and average of Vit B12 levels increased from 244.87 to285.54 (P = 0.025) . In this group we had reduction in WBC from 7.27 to6.62 (P=0.005) and increase in MCV from 86.64 to 88.81 (P= 0.002) . Treatment with folic acid didnâ��t have significant effect on, Hemoglobin, & Platelets. In placebo group homocysteine increased from 14.4 to 17.1 (P= 0.007) and Vit B12 decreased from 211.8 to 187.04 ( P = 0.063 ) . Also, in this group there was no significant change in WBC, MCV & plateletes. But we had reduction in hemoglobin level form 14.94 to 14.72 in this group . (P = 0.036) Conclusion: Complementary treatment with folic acid in patients with typeâ i diabetes that are on metformin can prevent increasing Homocysteine levels. Also, this treatment can increase B12 levels. Therefore, it is useful to use folic acid for these patients.