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Association of metformin, elevated homocysteine and methylmalonic acid levels, and clinically worsened diabetic peripheral neuropathy
Diabetes Care, 10/30/09
Wile DJ et al. – Metformin exposure may be an iatrogenic cause for exacerbation of peripheral neuropathy in patients with type 2 diabetes. Interval screening for Cbl deficiency and systemic Cbl therapy should be considered upon initiation of, as well as during, metformin therapy to detect potential secondary causes of worsening peripheral neuropathy.
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