Evidence mapPaperPMID 41087811Full record

ReviewHormones (Athens, Greece)2026

What ultimately underlies vitamin B12 and folate deficiency in subjects treated with biguanides?

Theodoros Panou, Byron Asimakopoulos

Abstract readReview
PubMed Publisher
In one paragraph

Review in Hormones (Athens, Greece), 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

2 authors.

Theodoros PanouLaboratory of Physiology, Faculty of Medicine, Democritus University of Thrace, 68100, Alexandroupolis, Greece.
Byron AsimakopoulosLaboratory of Physiology, Faculty of Medicine, Democritus University of Thrace, 68100, Alexandroupolis, Greece. basima@med.duth.gr.ORCID http://orcid.org/0000-0003-4754-6177

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeMetformin, the main biguanide in clinical settings, is the most common antidiabetic agent worldwide and has for years been regarded as a safe treatment option mostly for subjects with type II diabetes mellitus. Nevertheless, long-term metformin treatment leads to vitamin B12 and/or folic acid/folate deficiency in a significant portion of metformin recipients. As these deficiencies, and particularly in the case of vitamin B12, may lead to severe suboptimal health outcomes and are frequently encountered, the current review provides a comprehensive insight into the underlying mechanisms.

methodsFor this purpose, a literature search in PubMed and SCOPUS was conducted using appropriate keywords.

resultsThe mechanisms responsible for the deficiency have not thus far been fully elucidated. Early studies focused mainly on the impaired function of the intrinsic factor, responsible for the absorption of vitamin B12, and several intestinal brush border enzymes. The vitamin deficiency was found to be either temporary or else persistent. Recent studies point to the crucial role of several bacteria and their gut-host interactions, as several mechanisms were observed in experimental studies for the capture of vitamin B12 from the host. Other basic research studies found instead a redistribution of vitamin B12 without a remarkable effect on the total amount. The administration of calcium or miglitol has been found to constitute potential ways to compensate for the deficiencies observed.

conclusionA deeper understanding of the mechanisms driving this deficiency will pave the way to a causative treatment for and even prevention of this major side effect.

Indexed as

BiguanidesDiabetes Mellitus, Type 2Folic Acid DeficiencyHypoglycemic AgentsMetforminVitamin B 12 DeficiencyFolic AcidHumansVitamin B 12BiguanidesFolic AcidHypoglycemic AgentsMetforminVitamin B 12BiguanideDiabetes mellitusFolic acidMetforminVitamin B12

Identifiers

What Socratic holds

Texttitle and abstract
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.