High Surgical Rate in Orbital Cellulitis Demands Targeted Management: Study

China: A new study has found that over 80% of orbital cellulitis (OC) cases require surgical intervention, regardless of patient age, primarily due to abscess formation or failure of medical therapy. Staphylococcal species, including MRSA, are common causative agents, highlighting the need for customized empiric antibiotic regimens. Implementing cost-effective management strategies that consider Chandler staging and vaccination history is advised.

The retrospective study, published in The Journal of Craniofacial Surgery, analyzed 40 cases of orbital cellulitis that occurred over 12 years at Xi’an Fourth Hospital. The research team, led by Mingyang Wang from the Department of Ophthalmology, Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, assessed both pediatric and adult cohorts to identify clinical features, treatment outcomes, and factors predicting surgical intervention.

Among the patients studied, 13 were children and 27 were adults, with an overall mean age of 34.8 years. Surgical management emerged as a cornerstone of treatment, being necessary in 84.6% of pediatric and 88.9% of adult cases. The main reasons for operative intervention were the development of orbital abscesses and inadequate response to intravenous antibiotics alone.

The key findings of the study were as follows:

  • Staphylococcus aureus (17.1%) and Staphylococcus epidermidis (11.4%) were identified as the predominant organisms.
  • MRSA accounted for 8.6% of isolates.
  • Nearly one-third of patient cultures showed no bacterial growth, highlighting the need for empiric therapy.
  • Ceftriaxone was the most commonly used antibiotic (45%), followed by cefotaxime (7.5%).
  • Surgical intervention significantly increased treatment costs (¥13,317 ± ¥5,351 versus ¥1,843 ± ¥509 for non-surgical cases).
  • In adults, surgery was linked to improved visual outcomes, with mean visual acuity increasing from 0.5 ± 0.3 at presentation to 0.6 ± 0.4 at final follow-up.
  • All patients achieved complete resolution of symptoms.

The study highlights that OC remains a vision-threatening condition requiring prompt recognition and aggressive management. The high prevalence of staphylococcal infections, including MRSA, points to the need for carefully selected empiric antibiotic regimens tailored to local resistance patterns. The authors also emphasize the importance of incorporating Chandler staging and vaccination history into treatment algorithms to ensure a structured and cost-effective approach.

By providing comparative insights into pediatric and adult OC cases, the findings underline that the requirement for surgical intervention transcends age groups. According to the authors, adopting a multidisciplinary approach that combines timely imaging, targeted antibiotics, and early surgical consideration is essential to prevent vision loss and systemic complications.

“The large-scale analysis reinforces the critical role of individualized management in orbital cellulitis and offers valuable guidance for clinicians dealing with this potentially severe infection in both children and adults,” the authors concluded.

Reference:

Wang, Mingyang MD*,†; Qin, Bixuan MD‡; Fu, Junxia MD§; Zhang, Ju MD*; Liu, Honglei MD‖; Li, Dongmei MD*,‡. Orbital Cellulitis Management in Pediatric and Adult Cohorts: A 12-Year Retrospective Analysis From a Tertiary Center. The Journal of Craniofacial Surgery ():10.1097/SCS.0000000000011711, July 30, 2025. | DOI: 10.1097/SCS.0000000000011711

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Can botox be used to alleviate pain in a jaw disorder?

Temporomandibular disorder (TMD) limits jaw function and is so painful that it lessens the quality of life. Botulinum toxin-also known as botox-is emerging as an effective treatment option, but there are concerns about side effects, like muscle dysfunction. Eungyung Kim and Yu Shin Kim, from the University of Texas Health Science Center at San Antonio, led a study using a mouse model of TMD to explore the possibility of using botox as a treatment.

In their JNeurosci paper, the researchers discovered that injecting botox directly into the male mouse temporomandibular joint (TMJ) instead of surrounding muscle tissue reduced TMD-related pain without causing side effects.

More specifically, hypersensitivity and pain from TMD were mitigated without impairing general movement abilities and feeding behavior. The researchers also found that the botox injections they delivered reduced TMD-related neural activity. On a molecular level, mice that received botox injections into the TMJ had less expression of proteins that promote pain.

While sex differences remain unexplored, according to the authors, this work suggests it may be possible to overcome botox side effects by avoiding muscle tissue and injecting the toxin directly into the TMJ. 

Reference:

Eungyung Kim, Hyeonwi Son, Yan Zhang, John Shannonhouse, Ruben Gomez, BoNT injection into temporomandibular joint alleviates TMJ pain in forced mouth opening mouse model, JNeurosci, https://doi.org/10.1523/JNEUROSCI.2035-24.2025 

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Early Drug Resistance in Focal Epilepsy Linked to Seizure Frequency and Psychiatric History: JAMA

Australia: A new study published in JAMA Neurology highlights that most people with newly diagnosed focal epilepsy take more than a year and often require multiple antiseizure medications (ASMs) to achieve seizure freedom. The research, led by Sarah N. Barnard and colleagues from the School of Translational Medicine at Monash University, further indicates that patients with frequent pretreatment seizures and psychiatric comorbidities are at greater risk of developing drug resistance.

“Patients with newly diagnosed focal epilepsy needed extended treatment—often exceeding a year and involving more than one ASM—to attain seizure freedom, while baseline seizure frequency and mental health issues were strong indicators of treatment resistance,” the authors wrote.
The findings are from the Human Epilepsy Project, an international, prospective cohort study that followed participants across 34 epilepsy centers in the US, Australia, and Europe for up to six years. The study aimed to quantify treatment response and identify predictors of resistance among individuals with newly diagnosed focal epilepsy. Participants aged 12 to 60 years were enrolled within four months of initiating ASM therapy and closely monitored to assess outcomes using standardized definitions from the International League Against Epilepsy.
The analysis of 448 participants yielded several significant findings:
  • 59.6% of participants eventually became seizure-free, with 83.5% of these maintaining remission without relapse.
  • Early control was uncommon; during the first year of therapy, 63% of patients continued to experience seizures or worsening symptoms.
  • Most patients required more than one ASM trial to achieve stability, and the median time to seizure freedom was 12.1 months.
  • For those who never relapsed, this milestone was reached much sooner—around 2.2 months—compared to 7.4 months for those who experienced recurrence.
  • More than half of the cohort (54.7%) were classified as treatment-sensitive, achieving seizure control with two or fewer adequate ASM trials, and nearly 90% of these responded to monotherapy.
  • About half of the treatment-sensitive group, representing 27% of the total study population, became seizure-free on their first ASM.
  • Treatment resistance was seen in 22.8% of participants, while 22.5% had outcomes that did not fit either category.
  • The study identified important predictors of resistance. Patients who experienced frequent seizures before treatment were significantly more likely to fail therapy compared to those with infrequent episodes.
  • Individuals with a history of psychiatric disorders had an approximately 1.8-fold higher risk of developing treatment resistance than those without such conditions.
According to the authors, recognizing these risk factors early can help clinicians tailor treatment strategies and reduce the time to seizure control. The findings highlight the importance of individualized care, taking into account seizure frequency and mental health history when managing newly diagnosed focal epilepsy.
Reference:
Barnard SN, Chen Z, Holmes M, et al. Treatment Response to Antiseizure Medications in People With Newly Diagnosed Focal Epilepsy. JAMA Neurol. Published online August 25, 2025. doi:10.1001/jamaneurol.2025.2949

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Combination therapy improves outcomes for advanced triple-negative breast cancer: Study

 A new study led by researchers at the Icahn School of Medicine at Mount Sinai has found that adding the targeted therapy everolimus to standard carboplatin chemotherapy extends the time before disease progression in patients with advanced triple-negative breast cancer (TNBC), one of the most aggressive and hard-to-treat forms of breast cancer.

The randomized phase 2 clinical trial, published in Breast Cancer Research and Treatment, showed that patients receiving the combination treatment experienced a 52 percent reduction in the risk of disease progression or death compared to those treated with carboplatin alone. The regimen was well tolerated, with no unexpected safety concerns.

“Triple-negative breast cancer has limited treatment options and is often resistant to standard therapies,” said senior author Amy Tiersten, MD, Professor of Medicine (Hematology and Medical Oncology) at the Icahn School of Medicine. “Our findings suggest that the combination of carboplatin and everolimus could offer a new option for patients, and should be further tested in larger clinical trials to confirm its effectiveness and safety.”

According to the American Cancer Society, triple-negative breast cancer is a type of breast cancer that makes up about 10 to 15 out of every 100 cases. It’s tougher to treat and can be more dangerous than other kinds of breast cancer.

Many TNBC tumors are missing something called the PTEN gene, which usually helps keep cell growth under control. Without PTEN, a “growth switch” called the mTOR pathway gets turned on, making the cancer grow faster. Everolimus can block this switch, which may slow down or even stop the cancer from spreading.

In this study, Mount Sinai doctors worked with patients whose TNBC had already been treated up to three times before. They randomly chose some patients to receive carboplatin (a common chemotherapy) alone, while others got carboplatin plus everolimus. The patients who got both medicines lived without their cancer getting worse for longer than those who got only chemotherapy. “This combination could represent a promising new treatment option for advanced triple-negative breast cancer if validated in phase 3 trials,” said Rima Patel, MD, Assistant Professor of Medicine (Hematology and Medical Oncology) at the Icahn School of Medicine and first author of the study.

Future phase 3 studies will be needed to confirm the efficacy of carboplatin and everolimus in metastatic TNBC. If the efficacy of the combination is confirmed in larger studies, carboplatin and everolimus could be considered another treatment option for patients with TNBC in lieu of offering carboplatin or another single-agent chemotherapy alone.

Reference:

Patel, R., Fukui, J., Klein, P. et al. Randomized phase II comparison of single-agent carboplatin versus combination of carboplatin and everolimus for advanced triple negative breast cancer. Breast Cancer Res Treat (2025). https://doi.org/10.1007/s10549-025-07802-7

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Osteoarthritis Linked to Increased Risk of Sleep Apnea, Study Finds

Researchers have discovered in a new study that patients with osteoarthritis (OA) are at higher risk of developing sleep apnea (SA), a disease with high morbidity and mortality. Osteoarthritis is the most prevalent joint disease, leading to chronic pain and inflammation, two established risk factors for sleep apnea. The study was published in the journal of Clinical Rheumatology by Yanqiu Zhu and colleagues.

The purpose of the current study was to examine whether OA, such as knee, hip, and hand OA, is linked with a higher risk of sleep apnea. Employing data from the IQVIA Medical Research Database, three individual cohort studies were performed to evaluate the rate of SA among persons with OA versus those without OA.

The research utilized a cohort design of participants who were 50 years and older, stratified into three cohorts according to the type of OA (knee, hip, and hand OA). Each OA patient was matched with a maximum of five non-OA patients according to age, sex, entry-time, and body mass index (BMI) to control for confounding factors.

OA Cohorts:

  • Knee OA: 58,674 patients

  • Hip OA: Not explicitly given in the summary

  • Hand OA: Not specifically provided within the summary

Non-OA Cohorts:

  • Knee OA Comparison Group: 235,850 non-OA participants

The risk incidence of SA was estimated separately within OA and non-OA groups. Cox proportional hazard regression was employed to estimate the association of OA with developing SA, controlled for suspected confounders .

Key Findings

Knee Osteoarthritis

  • SA Incidence: 2.29 per 1,000 person-years for the OA group versus 1.41 per 1,000 person-years for the non-OA group.

  • Risk Increase: Knee OA patients had a 45% increased risk of developing SA (adjusted hazard ratio [HR]: 1.45, 95% confidence interval [CI]: 1.34–1.56).

Hip Osteoarthritis:

  • Risk Increase: Hip OA patients also had a 45% increased risk of SA (adjusted HR: 1.45, 95% CI: 1.28–1.66).

Hand Osteoarthritis:

  • Risk Increase: Hand OA patients had a 50% increased risk of SA (adjusted HR: 1.50, 95% CI: 1.26–1.78).

This study has concluded that patients with knee, hip, and hand osteoarthritis are at significantly increased risk of developing sleep apnea relative to those without OA. These results underscore the need to consider sleep apnea as a possible comorbidity in OA patients and indicate that targeted screening, prevention, and treatment strategies for sleep apnea in OA patients may be an effective way to decrease the overall disease burden.

Reference:

Zhu, Y., Jiang, Q., Zhang, Y. et al. Osteoarthritis and the risk of sleep apnea: a general population-based cohort study. Clin Rheumatol (2025). https://doi.org/10.1007/s10067-025-07457-1

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Bihar Govt approves stipend hike: MBBS, BDS, AYUSH, FMG interns to get Rs 27k per month

Patna: Offering respite to the MBBS, BDS, and AYUSH interns in Bihar, the State Government has announced a stipend hike. Now, the MBBS, BDS, Ayurvedic, Unani, and Homoeopathy Interns in the government medical colleges, Patna Dental College and other institutes across the State will get Rs 27,000 per month. Previously, they used to get Rs 20,000 per month as their stipend.

Apart from this, the State has also announced to give a Rs 27,000 monthly stipend to the Foreign Medical Graduates undergoing mandatory internship in the State’s Government medical colleges.

Meanwhile, the Physiotherapy and Occupational Therapy interns will get Rs 20,000 per month as their stipend, announced the Bihar Government.

Medical Dialogues had earlier reported that the MBBS interns of the State-run Patna Medical College and Hospital (PMCH) were on a protest demanding a hike in their monthly stipend. They had also threatened to intensify their protest by disrupting the out-patient department (OPD) services if their monthly stipend was not increased.

The MBBS interns at PMCH, who were receiving approximately Rs 20,000 as a monthly stipend, were demanding a hike in the stipend amount from Rs 20,000 per month to Rs 40,000 per month.

According to the intern doctors, the State Government had last revised the monthly internship allowance back in 2022, with an assurance to revise it again after three years.

While the MBBS interns across 10 other medical colleges under the Bihar government used to get a monthly stipend of around Rs 19,600, the MBBS interns at IGIMS get Rs 30,000 as a monthly stipend, while those at AIIMS get Rs 32,000.

Meanwhile, the intern doctors in West Bengal and Odisha get Rs 43,000 and Rs 40,000 per month, respectively. Therefore, the interns were urging the State to take immediate action to revise the stipend structure and bring Bihar at par with other States. 

Also Read: Bihar MBBS Interns on Strike Demanding Stipend Hike to Rs 40k

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Supreme Court upholds Telangana’s domicile rule for MBBS admissions

New Delhi: Allowing the appeal of the Telangana Government, the Supreme Court recently upheld the State’s domicile rule that permitted students who have studied for the last four years up to Class 12 in the state, for admissions in medical and dental colleges under the state quota.

In its order, the Apex Court bench comprising Chief Justice B R Gavai and Justice K Vinod Chandran upheld the Telangana Medical and Dental Colleges Admission (Admission into MBBS & BDS Courses) Rules, 2017, which was amended in 2024.

Under this rule, to be eligible for admission to state quota medical and dental seats through the National Eligibility-Entrance Test (NEET), a student must have pursued Classes 9 to 12 in the State.

Earlier, the domicile policy was challenged before the Telangana High Court. Medical Dialogues had earlier reported that more than 50 pleas were filed before the Telangana HC challenging the validity of Rule 3(a) of the Telangana Medical and Dental Colleges Admission (Admission into MBBS & BDS Courses) Rules 2017 as amended vide the GO dated July 19, 2024, which made it mandatory for the MBBS and BDS aspirants to study continuously from Classes 9 to 12 in the State.

While considering the matter, the Telangana HC had held that permanent residents of the State did not need to study in Telangana for 4 continuous years for MBBS and BDS admission in the domicile quota seats. The HC bench had observed that the State’s permanent residents could not be denied benefits of admissions in medical colleges only because they lived outside the State for some time.

However, the HC Division bench of Chief Justice Alok Aradhe and Justice J. Sreenivas Rao had declined to strike down Rule 3(a) of the 2017 Rules, which prescribes the criteria for local candidates, in its entirety.

Also Read: Supreme Court to decide on Telangana domicile quota for MBBS admissions

Back then, the HC bench had reasoned that striking down the provision in its entirety would have the unintended consequence of opening the State quota seats to students from across the country. Instead, the Court had read down the rule to exempt permanent residents of Telangana from the four-year study requirement, while holding that the interpretation in this regard was consistent with Article 371D(2)(b)(ii) of the Constitution, which empowers States to frame special provisions for local candidates in educational institutions.

However, challenging the HC order, the State had approached the top court bench. In its appeal, the Telangana Government argued that the High Court’s expansion of the definition of a “local candidate” undermined the special protection under Article 371D, which was designed to ensure preferential access for students genuinely integrated into the State’s educational system.

On the other hand, the students argued that the definition was unduly rigid and overlooked circumstances such as the transfer of parents in government or allied services, due to which, children get forced to pursue their studies outside of Telangana despite maintaining strong ties to the State.

The top court on August 5 reserved its verdict on the pleas, including one from the Telangana government, against the HC order that struck down its domicile rule for admissions in medical colleges in the state. The state was represented by senior advocate Abhishek Singhvi and lawyer Sravan Kumar Karnam, PTI has reported.

Now, the Apex Court bench comprising Chief Justice of India B.R. Gavai and Justice K. Vinod Chandran allowed the State’s appeal and affirmed the constitutionality of the Telangana Medical and Dental Colleges Admission Rules, 2017 (2017 Rules) as amended in 2024.

“The appeals of the State and the university are allowed, setting aside both the impugned high court judgments. The students’ writ petitions stand dismissed,” observed the bench.

As per the latest media report by The Hindu, while setting aside the High Court bench’s order, the top court bench observed that in the absence of a statutory definition of residence or a prescribed framework for issuing residence certificates, the directions would result in an “anomalous situation”, rendering the domicile unworkable and exposing it to a spate of litigation.

Further, the rule took note of a further amendment proposed by the State Government, adding a proviso to Rule 3 to permit candidates who had studied outside Telangana during the four qualifying years to still be treated as local candidates if they belonged to specified categories, including children of State government employees, All India Services officers, defence personnel, or employees of State corporations and agencies subject to all-India transfers.

“The said proviso should allay and mitigate the grievances of those who claim that they were taken out of the State by compulsion of the movement of their parents outside the State by reason of employment in Government/All-India Services/ Corporations or Public Sector Undertakings constituted as an instrumentality of the State of Telangana as also defence and paramilitary forces who trace their nativity to the State,” observed the Supreme Court.

Further, the Apex Court clarified that the admissions made in the previous academic order, based on a concession extended by the government to mitigate the hardship, would not be disturbed.

Also Read: NEET: SC slams Telangana’s domicile policy, says students who go outside state seeking better education shouldn’t be penalised

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HC strikes down 79% reservation in medical colleges, imposes 50% cap in UP

The Allahabad High Court’s Lucknow bench has quashed Uttar Pradesh government orders that resulted in over 79 percent reservation in government medical colleges in 4 districts.

The direction came on a petition by a NEET 2025 candidate who argued that the state’s orders between 2010–2015 unlawfully pushed reservation beyond the 50% cap, leaving just seven out of 85 seats for the unreserved category. Rejecting the state’s reliance on the Indira Sawhney case, the court ruled that any hike in reservation must follow due legal process. It directed the state to refill seats strictly in line with the UP Reservation Act, 2006, ensuring the 50% ceiling is not crossed.

For more details, check out the full story on the link mentioned below:

HC quashes 79 percent reservation in UP govt medical colleges, orders strict 50 percent cap

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Delhi HC directs private hospital to treat 12-year-old under EWS category

New Delhi: Taking suo motu cognisance of a newspaper report about a 12-year-old boy who was critically injured and was denied admission to government hospitals due to the unavailability of ICU beds, the Delhi High Court directed a private hospital, where the boy was eventually admitted despite his family’s poor financial condition, to provide treatment under the Economically Weaker Section (EWS) category and refrain from demanding any payment from his parents.

A division bench of Justices Prathiba M Singh and Manmeet PS Arora further ordered that Shree Aggrasain International Hospital may make its submissions on the next date of hearing, but, in the meantime, must continue to provide all necessary and adequate treatment for the child’s recovery without charging the parents.

On being informed about the need to broaden the eligibility criteria for the EWS category, since many private hospitals fail to extend mandated facilities despite being under a binding obligation, the bench directed that this issue too shall be taken up on the next date, and counsels for all parties, including the Delhi government, should make their submissions.

Also read- Paramedical staff crucial for health management: Delhi HC directs immediate recruitment

The case concerns a 12-year-old boy who sustained severe injuries after he slipped from the first floor of his house on 19th August, 2025, as reported by TOI on August 29. The boy’s father is a daily wager and faced enormous challenges in finding a ventilator bed at any government hospital in the capital, following which the minor was taken to the Shree Aggrasain International Hospital, Rohini, New Delhi.

The news report also states that the parents of the child were looking for an ICU bed in various hospitals across Delhi, including the Safdarjung Hospital and other Delhi Government hospitals. However, due to their inability to find any ICU bed in any government hospital across the city, the child had to be admitted to a private hospital.

The Bench, which spoke to the child’s uncle over a phone call, was initially considering moving the boy to a government hospital. However, noting the progress in the child’s medical condition, the court decided not to shift him from the current facility.

The court further made it clear till the next date, the hospital will not demand money and continue to treat the child properly.

“The child shall be considered in the EWS category, and no payment shall be demanded by the hospital from the parents of the child till the next date of hearing. Issue notice to the hospital. On the next date, the hospital may make its submissions,” the bench said, posting the matter for September 2. The order would be communicated to the head of the hospital.

Advocate Ashok Agarwal, who was appointed amicus curiae by the court in another case relating to the implementation of the Hospital Management Information System (HMIS), said in the EWS category, the criteria deserve to be increased in the case of hospitals, for most private hospitals did not properly extend medical facilities to the category, though under a binding obligation.

The news report claimed that a few days into his treatment at the government hospital, the child complained of severe headache, nose bleeding and vomiting and was rushed to the private hospital. The report said the family tried to get an admission in Ambedkar Hospital but was turned down twice and was asked to go to hospitals such as G B Pant or Safdarjung.

The child’s father was caught between mounting medical bills and the absence of support in government hospitals. He said he earns a few thousand rupees a month and has already spent Rs 2 lakh on his son’s treatment after borrowing money.

Recently, the Delhi government health secretary informed the high court that once the HMIS was fully implemented, ICU bed availability would begin in real time, reports PTI.

To view the official order, click on the link below: 

Also read- Doctor challenges ‘arbitrary’ revaluation clause in DNB exam- Delhi HC issues notice to NBE, Centre

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Long-Term Metformin Use Linked to Vitamin B12 Deficiency and Neuropathy, Study Finds

USA: A recent study published in Diabetes Research and Clinical Practice highlights a significant concern for individuals with type 2 diabetes mellitus (T2DM) who are on long-term metformin therapy. Researchers, led by Aryana Sepassi from the University of California, San Diego Skaggs School of Pharmacy and Pharmaceutical Sciences, report that prolonged metformin use is strongly linked to vitamin B12 deficiency and an increased risk of peripheral neuropathy. The findings highlight the importance of routine vitamin B12 monitoring in patients on extended metformin therapy.

The analysis utilized data from the National Institutes of Health’s All of Us research program, providing a large real-world population sample that included 14,808 adults with T2DM. Among these, 61.7% reported metformin use, with nearly 38% classified as long-term users (≥4 years). Researchers employed a retrospective, observational cross-sectional design and compared vitamin B12 status and neuropathy prevalence between long-term users, short-term users (<4 years), and individuals who did not use metformin.
The key findings of the study were as follows:
  • Patients using metformin for four years or more had a 67% higher risk of vitamin B12 deficiency compared with non-users after adjusting for confounding factors.
  • The risk of vitamin B12 deficiency was 38% higher in long-term metformin users compared with those using metformin for a shorter period.
  • The prevalence of peripheral neuropathy was 39% higher among long-term users compared to those on short-term therapy.
  • The difference in neuropathy risk between long-term users and non-users was not statistically significant, but the trend indicated a concerning pattern.
  • The risk of vitamin B12 deficiency increased by approximately 3% for each year following the initiation of metformin therapy, suggesting a cumulative effect over time.
The study highlights a complex interplay between the duration of diabetes, metformin exposure, and neuropathy risk. This relationship emphasizes that neuropathic complications may not solely result from hyperglycemia but also from drug-induced nutritional deficiencies. According to the authors, these findings underscore the necessity of integrating vitamin B12 screening into routine care for patients undergoing prolonged metformin treatment, particularly when they present with symptoms of neuropathy.
The authors acknowledged limitations, including the observational design, which prevents establishing causality, and the inability to fully control for factors such as dietary habits, genetic predispositions, coexisting conditions like anemia, and adherence to vitamin B12 supplementation. Additionally, missing medication history data may have influenced the outcomes.
The researchers conclude that as metformin continues to be widely prescribed—even beyond diabetes care—clinicians should remain vigilant about its long-term implications. Regular vitamin B12 monitoring and timely interventions could be critical in preventing neuropathy, distinguishing its underlying causes, and improving quality of life for patients.
Reference:
Sepassi, A., Wang, J., Yankowski, S., Enkoji, A., Okenwa, M., Morello, C. M., & Hurley-Kim, K. (2025). Associations between long-term metformin use, the risk of vitamin B12 deficiency, and neuropathy: An All of Us research Program study. Diabetes Research and Clinical Practice, 228, 112424. https://doi.org/10.1016/j.diabres.2025.112424

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