الفهرس 
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Abstract
Nearly 90% of all cases of diabetes mellitus (DM) are of type 2 diabetes (T2DM), which is the most prevalent type. Hyperglycemia, which commonly results from insufficient insulin production on the background of insulin resistance, is a hallmark of T2DM.
Alterations in cellular homeostasis brought on by persistent hyperglycemia in DM result in diffuse vascular damage and the emergence of long-term micro- and macrovascular complications. Damage to small blood arteries causes microvascular complications, such as diabetic neuropathy (DN), diabetic retinopathy and diabetic kidney disease (DKD).
Over the years, metformin has been regarded as the best and initial therapeutic option for the management of T2DM. Deficiency in vitamin B12 is one of the known negative effects of long-term metformin use.
The aim of the present study was to assess the levels of serum vitamin B12 in patients with T2DM and its relations with metformin usage index, vitamin B12 supplementations intake and peripheral neuropathy.
This study was conducted on 200 subjects divided into three groups: group (1) included 100 patients with T2DM treated with metformin for at least 12 months, further divided into 2 subgroups: 50 patients with T2DM treated with metformin for at least 12 months without vitamin B12 supplementation (group 1a) and 50 patients with T2DM treated with metformin for at least 12 months, on vitamin B12 supplementation (group 1b). group (2) consisted of 50 patients with T2DM not receiving metformin. And finally, 50 healthy subjects of matched age and sex as a control group (group 3).
After giving their signed informed consents, all participants underwent: full history taking, physical examination (including peripheral neuropathy assessment), laboratory assessment (complete blood count, glycated haemoglobin and serum vitamin B12).