<p> </p> <p class="MsoNormal" style="text-align:justify;text-justify:inter-ideograph"><b style="mso-bidi-font-weight:normal"><span lang="EN-IN" style="font-size:12.0pt;
line-height:115%;font-family:"Agency FB","sans-serif";mso-bidi-font-family:
"Times New Roman"">Background: </span></b><span lang="EN-IN" style="font-size:
12.0pt;line-height:115%;font-family:"Agency FB","sans-serif";mso-fareast-font-family:
MinionPro-Regular;mso-bidi-font-family:"Times New Roman"">Metformin is considered as the first-line antidiabetic agent in the treatment of type 2 diabetes mellitus (T2DM) due to its effect on glucose and lipid metabolism. </span><span lang="EN-IN" style="font-size:12.0pt;line-height:115%;font-family:"Agency FB","sans-serif";
mso-bidi-font-family:"Times New Roman";color:black">The mechanism of action of Metformin in improving hyperglycemia involves in improving the signaling of insulin together with suppressing hepatic gluconeogenesis. </span><b style="mso-bidi-font-weight:normal"><span lang="EN-IN" style="font-size:12.0pt;
line-height:115%;font-family:"Agency FB","sans-serif";mso-bidi-font-family:
"Times New Roman"">Methods: </span></b><span lang="EN-IN" style="font-size:12.0pt;
line-height:115%;font-family:"Agency FB","sans-serif";mso-bidi-font-family:
"Times New Roman"">45 patients with type-2 diabetic patients <span style="color:black">on metformin therapy </span><span style="mso-spacerun:yes"> </span>with an age ranged from 30 to 65 years along with 45 healthy controls were recruited from the<span style="mso-spacerun:yes">  </span>General Medicine Department of HMCH, Rourkela according to inclusion and exclusion criteria. <b style="mso-bidi-font-weight:
normal">Results: </b></span><span lang="EN-IN" style="font-size:12.0pt;
line-height:115%;font-family:"Agency FB","sans-serif";mso-bidi-font-family:
ArialMT">The mean age and BMI of both the cases and controls were </span><span lang="EN-IN" style="font-size:12.0pt;line-height:115%;font-family:"Agency FB","sans-serif";
mso-bidi-font-family:Garamond">48.62 ± 7.94 </span><span lang="EN-IN" style="font-size:12.0pt;line-height:115%;font-family:"Agency FB","sans-serif";
mso-bidi-font-family:ArialMT">and </span><span lang="EN-IN" style="font-size:
12.0pt;line-height:115%;font-family:"Agency FB","sans-serif";mso-bidi-font-family:
Garamond">43.52 ± 5.24; </span><span lang="EN-IN" style="font-size:12.0pt;
line-height:115%;font-family:"Agency FB","sans-serif";mso-bidi-font-family:
"Times New Roman"">28.04 ± 4.34 and 26.54 ± 3.32 </span><span lang="EN-IN" style="font-size:12.0pt;line-height:115%;font-family:"Agency FB","sans-serif";
mso-bidi-font-family:ArialMT">respectively. </span><span lang="EN-IN" style="font-size:12.0pt;line-height:115%;font-family:"Agency FB","sans-serif";
mso-bidi-font-family:"Times New Roman"">Mean serum vitamin B12 levels in the case group was <span style="color:black">217.45±86.32 </span>and in control was <span style="color:black">370.08±91.6</span>and the difference was statistically significant. <b style="mso-bidi-font-weight:normal">Conclusion: </b>Metformin which is first line oral hypoglycemic agent as recommended by ADA is significantly associated with decrease in vitamin B12. </span><span lang="EN-IN" style="font-size:12.0pt;line-height:115%;font-family:"Agency FB","sans-serif";
mso-bidi-font-family:Garamond;color:black">There is moderate correlation between the markers of B12 status and levels of fasting blood sugar as well as HbA1C. There is a significant correlation between insulin and C-peptide with the markers of vitamin B12 status.</span><b style="mso-bidi-font-weight:normal"><span lang="EN-IN" style="font-size:12.0pt;line-height:115%;font-family:"Agency FB","sans-serif";
mso-bidi-font-family:"Times New Roman""><o:p></o:p></span></b></p>