Knowledge and practice pattern of physicians regarding vitamin B₁₂ monitoring in metformin-treated patients with diabetes mellitus in Nigeria: A cross-sectional study
Abstract
Background: Prolonged metformin use in type 2 diabetes mellitus is associated with vitamin B₁₂ deficiency. However, routine monitoring remains poorly defined and implemented in resource-limited settings. The knowledge and practice pattern of physicians regarding vitamin B₁₂ monitoring in metformin-treated patients with diabetes mellitus in Nigeria was assessed.Methods: Adescriptive cross-sectional online survey was conducted among physicians in Nigeria. Information about knowledge of metformin-associated vitamin B₁₂ deficiency, current monitoring practices, and perceived barriers to routine screening were assessed.Results: A total of 283 physicians participated in the study. Overall, 65.0% of respondents were aware that long-term metformin therapy may cause vitamin B₁₂ deficiency. About 46% identified annual vitamin B₁₂ assessment as appropriate and 10% reported routinely assessing vitamin B₁₂ levels in metformin-treated patients. Serum vitamin B₁₂ was the most commonly used diagnostic method (43.1%). Only 15.2% of respondents had previously diagnosed metformin-associated vitamin B₁₂ deficiency in practice, and 29.0% reported routinely counselling patients about this risk. Major barriers to routine monitoring included lack of awareness (65.4%), non-availability of testing (52.3%), high cost (50.5%), and absence of clear clinical guidelines (43.5%). Majority (90.5%) expressed interest in further training, and 65.4% supportedincorporation of routine vitamin B₁₂ monitoring into…
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