This Article  • Full text  • PDF  • Send to a friend  • Save in My Folder  • Save to citation manager  • Permissions  Citing Articles  • Citation map  • Citing articles on HighWire  • Citing articles on ISI (9)  • Contact me when this article is cited  Related Content  • Similar articles in this journal

	Since this article does not have an abstract, we have provided the first 150 words of the full text and any section headings.

Metformin is a drug increasingly used as a first-line treatment for type 2 diabetes mellitus. In this country, there is less experience with the drug than in England and Europe, where it has been used for decades. The drug is well tolerated in most patients. The primary adverse effect discussed in the North American literature is lactic acidosis, which is seen in patients with renal insufficiency and those undergoing radiologic procedures using contrast dye. Another well-documented but little-discussed adverse effect, notably omitted from an article in the ARCHIVES on laboratory diagnosis of B₁₂ deficiency,¹ is biguanide-associated decreased levels of vitamin B₁₂. The following case highlights this problem.

Report of a Case

Our patient was a 63-year-old white man with a medical history of type 2 diabetes mellitus for 12 years. He was not a vegetarian and had no history of bowel surgery. He also had a 3-year history of chronic nausea and vomiting. . . . [Full Text of this Article]

Comment

THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES

Risk factors of vitamin B12 deficiency in patients receiving metformin.
Ting et al.
Arch Intern Med 2006;166:1975-1979.
ABSTRACT | FULL TEXT  

Drug Interactions of Medications Commonly Used in Diabetes
Triplitt
Diabetes Spectr. 2006;19:202-211.
FULL TEXT  

Does Metformin Interfere With Thiamine?
Alston
Arch Intern Med 2003;163:983-983.
FULL TEXT  

Metformin-Associated Vitamin B12 Deficiency
Andres et al.
Arch Intern Med 2002;162:2251-2252.
FULL TEXT