Diabetic neuropathy is nerve damage that can occur in people with diabetes. It is a common complication of diabetes and can be serious. Diabetics have a higher risk for peripheral neuropathies due to nerves being damaged by high blood glucose levels and high levels of fats. In addition, Metformin (the first-line drug of choice for type II diabetes) can cause B12 deficiency. Studies and case reports suggest that 10% - 30% of patients who take Metformin have reduced vitamin B12 absorption, and severity worsens with length of use.
Symptoms of diabetic neuropathy generally affect the legs and feet and can more rarely affect hands and arms.
Symptoms include:
Symptoms usually develop gradually. However, some people may not notice an issue until considerable nerve damage has been done.
60-70% of Diabetic patients will experience some form of Neuropathy.(1)
Diabetic peripheral neuropathy (DPN) may affect 50% of people with Type 1 and Type 2 diabetes and is a leading cause of foot amputation.(4)
References:
1) Peripheral Neuropathy Risk Factors + Facts, 2016 The Foundation for Peripheral Neuropathy
2) Buvat DR. Use of metformin is a cause of vitamin B12 deficiency. Am Fam Physician 2004;69:264.
3) Bauman WA, Shaw S, Jayatilleke K, Spungen AM, Herbert V. Increased intake of calcium reverses the B12 malabsorption induced by metformin. Diabetes Care 2000;23:1227-31
4) Diabetic Neuropathy. Nat Rev Dis Primers. 2019 Jun 13;5(1):42. https://pmc.ncbi.nlm.nih.gov/articles/PMC7096070/
5) Diabetes and Foot Amputation. American College of Foot and Ankle Surgeons. https://www.acfas.org/who-we-are/about-acfas/health-information-fact-sheets/diabetes-and-foot-amputation
