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Emmanuel Andrès, MD; Laure Federici, MD

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

We read with interest the excellent article by Ting and colleagues¹ about risk factors of vitamin B₁₂ deficiency in patients receiving metformin. We would like to offer some findings from our own experience. To date, more than 30 patients with metformin-associated vitamin B₁₂ deficiency have been registered in a cohort study of cobalamin deficiency in the University Hospital of Strasbourg, Strasbourg, France (partial data were previously published²). An analysis of these patients (median age, 66 years) proves some of the comments by Ting et al.¹ First, the clinical severity of metformin-associated vitamin B₁₂ deficiency is moderate, with 90% of minor hematological abnormalities (median hemoglobin levels and mean erythrocyte cell volume, 11.5 g/dL and 95.4 fL, respectively) and 30% of mild peripheral sensitive neuropathy. However, there were 2 cases (5.7%) of symptomatic anemia and pancytopenia (requiring transfusions). The mean ± SD serum vitamin B₁₂ and total . . . [Full Text of this Article]

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