Knowledge of metformin-induced vitamin B-12 deficiency and its association with Alzheimer's disease among medical graduates

Metformin is commonly prescribed as first-line therapy for type 2 diabetes mellitus. Despite its clinical benefit. long-term use has been associated with vitamin B-12 deficiency, which can lead to neurological dysfunction and cognitive disorders, including Alzheimer’s disease. Awareness of this drug-nutrient interaction among healthcare professionals is essential for safe and effective diabetes management. This study evaluated and compared the knowledge of metformin-related vitamin B-12 deficiency and its neurological implications among medical and pharmacy graduates in Libya. A cross-sectional survey was conducted from February to May 2024 among 100 recent graduates (50 medical and 50 pharmacy). The self-designed questionnaire assessed 27 questions that structured knowledge of diabetes pathophysiology, metformin pharmacotherapy, mechanisms of vitamin B-12 deficiency, and its potential association with Alzheimer’s disease. Comparisons were performed using the Chi-square test. Pharmacy graduates demonstrated higher overall knowledge of diabetes management compared with medical graduates (77.2% vs. 66.4%; OR=1.72; p