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10.1111/jgs.14761 http://scihub22266oqcxt.onion/10.1111/jgs.14761 C5435502!5435502!28182265     free     free     free Deprecated: Implicit conversion from float 227.6 to int loses precision in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 534 Deprecated: Implicit conversion from float 227.6 to int loses precision in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 534 Deprecated: Implicit conversion from float 227.6 to int loses precision in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 534 Deprecated: Implicit conversion from float 227.6 to int loses precision in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 534 Deprecated: Implicit conversion from float 227.6 to int loses precision in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 534 Deprecated: Implicit conversion from float 227.6 to int loses precision in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 534       J+Am+Geriatr+Soc 2017 ; 65 (5): 1061-6 Nephropedia Template TP {{tp|p=28182265|t=2017. Long-term Metformin Therapy and Monitoring for Vitamin B12 Deficiency among Older Veterans |pdf=|usr=}}{{28182265}} gab.com Text Long-term Metformin Therapy and Monitoring for Vitamin B12 Deficiency among Older Veterans JO: J Am Geriatr Soc http://www.kidney.de/pget.php?&tw=1&pmid=28182265 #FOAvip OBJECTIVE: To examine the association between long-term metformin therapy and serum vitamin B12 monitoring. DESIGN: Retrospective cohort study. SETTING: A single Veterans Affairs Medical Center (VAMC), 2002-2012. PARTICIPANTS: Veterans 50 years or older with either Type 2 diabetes and long-term metformin therapy (n=3,687) or without diabetes and no prescription for metformin (n=13,258). MEASUREMENTS: We determined diabetes status from outpatient visits, and defined long-term metformin therapy as a prescription ?500 mg/day for at least six consecutive months. We estimated the proportion of participants who received a serum B12 test and used multivariable logistic regression, stratified by age, to evaluate the association between metformin use and serum B12 testing. RESULTS: Only 37% of older adults with diabetes receiving metformin were tested for vitamin B12 status after long-term metformin prescription. The mean B12 concentration was significantly lower in the metformin-exposed group (439.2 pg/dL) compared to those without diabetes (522.4 pg/dL) (P=0.0015). About 7% of persons with diabetes receiving metformin were vitamin B12 deficient (<170 pg/dL) compared to 3% of persons without diabetes or metformin use (P=0.0001). Depending on their age, metformin users were 2- to 3-times more likely not to receive vitamin B12 testing compared to those without metformin exposure, after adjusting for sex, race and ethnicity, body mass index, and number of years treated at the VAMC. CONCLUSION: Long-term metformin therapy is significantly associated with lower serum vitamin B12 concentration, yet those at risk are often not monitored for B12 deficiency. Because metformin is first line therapy for Type 2 diabetes, clinical decision support should be considered to promote serum B12 monitoring among long-term metformin users for timely identification of the potential need for B12 replacement. Twit Text FOAVip Long-term Metformin Therapy and Monitoring for Vitamin B12 Deficiency among Older Veterans ????J Am Geriatr Soc http://www.kidney.de/pget.php?&tw=1&pmid=28182265 #FOAvip Twit Text # Free Paper on # # # # # LINK http://www.kidney.de/pget.php?&tw=1&pmid=28182265 #FOAvip English Wikipedia <ref>{{Cite pmid|28182265}}</ref> Long-term Metformin Therapy and Monitoring for Vitamin B12 Deficiency among Older Veterans #MMPMID28182265 Kancherla V; Elliott JL; Patel BB; Holland NW; Johnson TM; Khakharia A; Phillips LS; Oakley GP; Vaughan CP J Am Geriatr Soc 2017[May]; 65 (5): 1061-6 PMID28182265show ga OBJECTIVE: To examine the association between long-term metformin therapy and serum vitamin B12 monitoring. DESIGN: Retrospective cohort study. SETTING: A single Veterans Affairs Medical Center (VAMC), 2002-2012. PARTICIPANTS: Veterans 50 years or older with either Type 2 diabetes and long-term metformin therapy (n=3,687) or without diabetes and no prescription for metformin (n=13,258). MEASUREMENTS: We determined diabetes status from outpatient visits, and defined long-term metformin therapy as a prescription ?500 mg/day for at least six consecutive months. We estimated the proportion of participants who received a serum B12 test and used multivariable logistic regression, stratified by age, to evaluate the association between metformin use and serum B12 testing. RESULTS: Only 37% of older adults with diabetes receiving metformin were tested for vitamin B12 status after long-term metformin prescription. The mean B12 concentration was significantly lower in the metformin-exposed group (439.2 pg/dL) compared to those without diabetes (522.4 pg/dL) (P=0.0015). About 7% of persons with diabetes receiving metformin were vitamin B12 deficient (<170 pg/dL) compared to 3% of persons without diabetes or metformin use (P=0.0001). Depending on their age, metformin users were 2- to 3-times more likely not to receive vitamin B12 testing compared to those without metformin exposure, after adjusting for sex, race and ethnicity, body mass index, and number of years treated at the VAMC. CONCLUSION: Long-term metformin therapy is significantly associated with lower serum vitamin B12 concentration, yet those at risk are often not monitored for B12 deficiency. Because metformin is first line therapy for Type 2 diabetes, clinical decision support should be considered to promote serum B12 monitoring among long-term metformin users for timely identification of the potential need for B12 replacement. äLong-term Metformin Therapy and Monitoring for Vitamin B12 Deficiency (epmc).pdf DeepDyve Pubget Overpricing