Metformin and vitamin B 12 deficiency

A recent SMJ article (full text via Medscape) presented a case of B 12 deficiency neuropathy induced by metformin mistaken for diabetic neuropathy. This has been known for a while and I first mentioned it here. With increasing numbers of patients on metformin for years at a time we're more likely to see this. Don't forget PPI's can do it too.