Title:Physicians’ Perception About Use of Vitamin B12 in the Treatment or Prevention of Diabetic Neuropathy: A Cross-sectional Survey in Saudi Arabia
Volume: 18
Issue: 2
Author(s): Khaled K. Aldossari*, Sameer Al-Ghamdi, Jamaan Alzahrani, Maram S. Al Turki , Mai Almuhareb, Ziad G. Alanazi , Ziyad M. Alshahrani and Jencia Wong
Affiliation:
- Family & Community Medicine Department, College of Medicine, Prince Sattam Bin Abdulaziz University, Al-Kharj, Riyadh, Saudi Arabia
Keywords:
Diabetic neuropathy, primary care physicians, vitamin B12, cross-sectional study, supplementation, cobalamin.
Abstract:
Background: Diabetic neuropathy is a condition that is prevalent among type 2 diabetic
patients. Some physicians prescribe vitamin B12 or vitamin B complex supplements to improve
symptoms, but studies have shown that there is little to no evidence of vitamin B12 being an effective
treatment for diabetic neuropathy. Thus, this study aims to investigate local physicians’ knowledge
and tendency to prescribe vitamin B12 or vitamin B complex for the treatment or prevention
of diabetic peripheral neuropathy.
Methods: It was a cross-sectional study, conducted between May and November of 2019, in several
primary healthcare centers in different cities of Saudi Arabia. A total of 412 physicians with a
minimum of three years of experience answered a three-part questionnaire on their demographic information,
prescribing behavior, and knowledge of the relationship between vitamin B12 or vitamin
B complex and diabetic neuropathy.
Results: The study found that only 42% of the physicians believed that vitamin B12 supplementation
did not prevent diabetic neuropathy, while only 52.7% found it to be an ineffective treatment
for this condition. Moreover, 58.7% stated that they had certainly prescribed vitamin B12 or multivitamins
as a form of treatment or prevention of diabetic neuropathy. 47.8% of the patients requested
a vitamin B12 prescription 1-6 times from their physicians, while 31.6% of them requested it ≥
7 times, with 42.5% of physicians agreeing that their prescriptions of vitamin B12 had been a result
of patient demand more than clinical justification. Likewise, 43% of respondents were aware
that vitamin B12 levels should be tested annually. Furthermore, a higher proportion of consultants
chose not to prescribe vitamin B12 to prevent or treat diabetic neuropathy than any other rank.
Conclusion: The findings of this study indicate a tendency of unnecessarily prescribing vitamin
B12 supplementation for the prevention or treatment of diabetic neuropathy as well as a lack of
knowledge on the matter among doctors in primary care hospitals in Saudi Arabia. The study has also
shown that there are patients who often request this prescription, adding pressure on their physicians
to comply. Future studies should investigate most of the hospitals in Saudi cities and include
less experienced residents and medical students.