<?xml version="1.0" encoding="ISO-8859-1"?><article xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance">
<front>
<journal-meta>
<journal-id>2312-3893</journal-id>
<journal-title><![CDATA[Revista Virtual de la Sociedad Paraguaya de Medicina Interna]]></journal-title>
<abbrev-journal-title><![CDATA[Rev. virtual Soc. Parag. Med. Int.]]></abbrev-journal-title>
<issn>2312-3893</issn>
<publisher>
<publisher-name><![CDATA[Sociedad Paraguaya de Medicina Interna]]></publisher-name>
</publisher>
</journal-meta>
<article-meta>
<article-id>S2312-38932025000100207</article-id>
<article-id pub-id-type="doi">10.18004/rvspmi/2312-3893/2025.e12122507</article-id>
<title-group>
<article-title xml:lang="es"><![CDATA[Factores asociados al déficit de vitamina B12 en personas mayores con diabetes mellitus tipo 2 tratadas con metformina]]></article-title>
<article-title xml:lang="en"><![CDATA[Factors associated with vitamin B12 deficiency in older people with type 2 diabetes mellitus treated with metformin]]></article-title>
</title-group>
<contrib-group>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Domínguez Gallardo]]></surname>
<given-names><![CDATA[Laura Andrea]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
</contrib-group>
<aff id="Af1">
<institution><![CDATA[,Universidad Nacional de Asunción Postgrado en Geriatría y Gerontología ]]></institution>
<addr-line><![CDATA[San Lorenzo ]]></addr-line>
<country>Paraguay</country>
</aff>
<pub-date pub-type="pub">
<day>00</day>
<month>00</month>
<year>2025</year>
</pub-date>
<pub-date pub-type="epub">
<day>00</day>
<month>00</month>
<year>2025</year>
</pub-date>
<volume>12</volume>
<numero>1</numero>
<fpage>207</fpage>
<copyright-statement/>
<copyright-year/>
<self-uri xlink:href="http://scielo.iics.una.py/scielo.php?script=sci_arttext&amp;pid=S2312-38932025000100207&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://scielo.iics.una.py/scielo.php?script=sci_abstract&amp;pid=S2312-38932025000100207&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://scielo.iics.una.py/scielo.php?script=sci_pdf&amp;pid=S2312-38932025000100207&amp;lng=en&amp;nrm=iso"></self-uri><abstract abstract-type="short" xml:lang="es"><p><![CDATA[RESUMEN  Introducción:  la metformina es el fármaco de primera línea en diabetes tipo 2. Sin embargo, está descrito que produce disminución de niveles plasmáticos de vitamina B12.  Objetivo:  determinar factores asociados al déficit de vitamina B12 en personas mayores con diabetes tipo 2 tratadas con metformina que acuden a consultorio externo de un centro público.  Metodología:  estudio observacional, descriptivo, de corte transversal, con componente analítico, realizado en personas mayores de 60 años con diabetes tipo 2 tratadas con metformina, en consultorio externo del Complejo Santo Domingo, Asunción, Paraguay, de junio a agosto 2024. Criterios de exclusión: gastrectomía o derivación gástrica, síndrome de malabsorción, alcoholismo, suplementación con B12, dieta vegetariana y pacientes que no firmaron el consentimiento. Muestreo no probabilístico de casos consecutivos. El tamaño de muestra calculado fue 158. Se consideró déficit de B12 a valores &#8804;203 pg/mL.  Resultados:  participaron 158 personas de 60 a 89 años, con edad media 73 ± 6 años, el 62% eran mujeres. El 67% cumplió con criterios de polifarmacia y el 21,5% consumía inhibidores de bomba de protones. El tiempo de uso de metformina fue de 7,71 ± 6,53 años, con dosis diaria 1389 ± 746,22 mg. El 38,6% presentó déficit de B12, más frecuente en mujeres, polimedicadas, sin consumo de IBP. El 86,7% presentó alteraciones en el hemograma: anemia (18,9%), leucopenia (8,2%) y trombocitopenia (6,3%). La concentración promedio de vitamina B12 fue 356 ±291,11 pg/mL (rango 90 - 2240 pg/mL). Se encontró asociación estadística con el tiempo de uso y dosis de metformina y el uso de inhibidores de bomba de protones.  Conclusiones:  la prevalencia de hipovitaminosis B12 fue 38,6%. Se observó asociación estadística con mayor dosis diaria y mayor tiempo de uso de metformina, pero no con mayor edad. En base a estos hallazgos, se recomienda buscar activamente la hipovitaminosis B12 en personas mayores tratadas con metformina.]]></p></abstract>
<abstract abstract-type="short" xml:lang="en"><p><![CDATA[ABSTRACT  Introduction:  Metformin is the first-line drug in type 2 diabetes. However, it has been described that it produces a decrease in vitamin B12 plasma levels.  Objective:  To determine factors associated with vitamin B12 deficiency in elderly people with type 2 diabetes treated with metformin attending an outpatient clinic in a public center.  Methodology:  Observational, descriptive, cross-sectional study, with an analytical component, carried out in elderly people over 60 years of age with type 2 diabetes treated with metformin, in the outpatient clinic of the Santo Domingo Complex, Asuncion, Paraguay, from June to August 2024. Exclusion criteria: gastrectomy or gastric bypass, malabsorption syndrome, alcoholism, B12 supplementation, vegetarian diet, and patients who did not sign the consent form. Non-probability sampling of consecutive cases. The calculated sample size was 158. B12 deficiency was considered at values &#8804;203 pg/mL.  Results:  One hundred fifty-eight people aged 60 to 89 years participated, with a mean age of 73 ± 6 years, 62% were women. Sixty-seven percent met polypharmacy criteria and 21.5% consumed proton pump inhibitors. The duration of metformin use was 7.71 ± 6.53 years, with a daily dose of 1389 ± 746.22 mg. The 38.6% presented B12 deficiency, more frequent in women, polymedicated, without PPI consumption. A total of 86.7% presented hemogram alterations: anemia (18.9%), leukopenia (8.2%) and thrombocytopenia (6.3%). The mean vitamin B12 concentration was 356 ±291.11 pg/mL (range 90 - 2240 pg/mL). Statistical association was found with the time of use and dose of metformin and the use of proton pump inhibitors.  Conclusions:  The prevalence of hypovitaminosis B12 was 38.6%. Statistical association was observed with higher daily dose and longer time of metformin use, but not with older age. Based on these findings, it is recommended to actively look for hypovitaminosis B12 in older people treated with metformin.]]></p></abstract>
<kwd-group>
<kwd lng="es"><![CDATA[deficiencia de vitamina B12]]></kwd>
<kwd lng="es"><![CDATA[metformina]]></kwd>
<kwd lng="es"><![CDATA[diabetes mellitus]]></kwd>
<kwd lng="es"><![CDATA[persona mayor]]></kwd>
<kwd lng="en"><![CDATA[vitamin B12 deficiency]]></kwd>
<kwd lng="en"><![CDATA[metformin]]></kwd>
<kwd lng="en"><![CDATA[diabetes mellitus]]></kwd>
<kwd lng="en"><![CDATA[elderly]]></kwd>
</kwd-group>
</article-meta>
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