From: Allen Jacobs, DPM
Dr. Udell appropriately indicates that the ordering of vitamin B12 levels may be appropriate in the patient with diabetes. Several other factors should be considered.
Vitamin B 12 deficiency is commonly encountered in diabetic patients not taking metformin. Jawa, et al. (Endocrine Practice, 16, 2010 ) noted in their study that as many as 48% of patients with diabetes not taking metformin demonstrate low levels of vitamin B 12 and that B12 deficiency is common in the diabetic patient. Carnell (Clinical Nutrition 94, 1 2011 ) addressed the possible unreliability of...
Editor's note: Dr. Jacobs' extended-length letter can be read here.
From: Elliot Udell, DPM
This finding is unfortunate because when examining the risk/benefit ratio, the evidence is clear that statin use has a greater benefit than risk. Statins reduce the incidence of myocardial infarctions and CVAs. I attended a lecture this past weekend given by an interventional radiologist who said that when he does balloon angioplasties to treat lower extremity arterial blockages, he places patients on statins to reduce the incidence of recurrences.
What is the relationship between the use of statins and incidence of diabetes? Are the pharmaceuticals the cause or is it the fact that people who are placed on statins already have risk factors for diabetes such as hyperlipidemia caused by overeating and lack of exercise? Are all statins implicated or only a select few?
Elliot Udell, DPM, Hicksville, NY
RE: Neuropathy Due to Vitamin B-12 Deficiency, Not Diabetes
From: Allen Jacobs, DPM
Allen Jacobs, DPM, St. Louis, MO
RE: Statins and the Incidence of Diabetes
From: David Secord, DPM
I'm finding it amazing how the evidence is stacking up on the use of statins and the incidence of diabetes. As such, I thought I'd pass this article along.
David Secord, DPM, Corpus Christi, TX
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