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Introduction: Metformin is the first drug of choice for type 2 diabetes mellitus unless it is contraindicated. Patients with maximum metformin dose and for longer duration may suffer from megaloblastic anemia. Material and Methods: A prospective, interventional, comparative study was conducted at a tertiary care teaching hospital. Type 2 diabetic patients on maximum metformin dose patients were advised to stop metformin and start long-acting insulin + DPPP4 inhibitors and injection of vitamin B12 to correct megaloblastic anemia. Result: The Mean ± SD hemoglobin, MCV, serum vitamin B12 level before and after the therapeutic modification were 9.1 ± 0.89 and 12.8 ± 1.02 gm/dl, 106.7 ± 1.23 and 93.12 ± 5.56 fL, respectively, 254.14 ± 58.12 and 468.13 ± 69.32 pg/mL,. Conclusion: Improvement in the Hemoglobin, MCV and serum vitamin B12 level suggestive of the cause of megaloblastic anemia was metformin.
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Ingole et al. (2024) studied this question.
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