3 min readNew DelhiMay 20, 2026 06:00 AM IST
Diabetes management is not only about sugar numbers. Long-term care also means monitoring nutrition, nerve health, and overall well-being. Small checks done at the right time can prevent bigger complications later. While Metformin is one of the most prescribed diabetes medicines, could it have side effects like reducing vitamin B12 levels or increasing nerve symptoms?
DISCLAIMER: This article is based on information from the public domain and/or the experts we spoke to. Always consult your health practitioner before starting any routine.
To get an informative insight, we reached out to Dr Vijay Negalur, HoD diabetology, KIMS Hospitals, Thane, who said that one “need not worry, but they should definitely stay aware”. “Metformin remains one of the safest and most effective medicines for type 2 diabetes and has proven long-term benefits for blood sugar control and heart health. However, prolonged use can reduce the body’s ability to absorb vitamin B12, especially in people taking higher doses or using it for several years. The issue is not the medicine itself, but missing the deficiency early,” said Dr Negalur.
Why is vitamin B12 so important in diabetes care?
Vitamin B12 plays a major role in nerve health, brain function, and red blood cell production. According to Dr Negalur, low levels may lead to numbness, tingling, burning feet, fatigue, memory issues, or weakness. “The challenge is that these symptoms can look very similar to diabetic neuropathy, so the deficiency often goes unnoticed unless specifically tested for,” said Dr Negalur.
Are certain patients at higher risk?
Yes, affirmed Dr Negalur. “The risk tends to increase in patients who have been on Metformin for many years, particularly at doses above 1500–2000 mg daily. Older adults, vegetarians, people with poor dietary intake, gastrointestinal disorders, or those already prone to anaemia may be more vulnerable. In clinical practice, we often see symptoms developing gradually rather than suddenly,” said Dr Negalur.
Close monitoring is essential (Photo: Getty Images/Thinkstock)
What symptoms should patients not ignore?
Persistent tiredness, dizziness, balance issues, pins-and-needles sensation, reduced walking tolerance, or unexplained brain fog should not be brushed aside as “just diabetes” or ageing. These may be subtle indicators of low B12 levels, he described.
Does this mean people should stop Metformin?
Absolutely not, clarified Dr Negalur. “Metformin continues to be a cornerstone treatment in diabetes management. The focus should be on periodic monitoring, not fear. A simple vitamin B12 evaluation during routine follow-ups can help detect deficiencies early, and supplementation, when required, is usually straightforward and effective.”
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DISCLAIMER: This article is based on information from the public domain and/or the experts we spoke to. Always consult your health practitioner before starting any routine.