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3- Medications of peptic ulcer and acid reflux disorder including Omeprazole (Prilosec), Famotidine (Pepcid AC), Ranitidine (Zantaz), and Lansoprazole (Prevacid) Why is the deficiency of Vitamin B12 so serious for diabetic patients

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Besides the acute phase gastrointestinal effects which may lead to up to 10% of people discontinuing the drugs, there are other potential GI side effects of obstruction, excessive loss of muscle mass, and potentially association with some eye disease adverse events

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For example, depending on the assay, serum B12 cutoffs for deficiency for adults may range from 120 to 180pmol/L, with 148pmol/L based on 3SDs from the mean of an adult reference range, said to be the most common cutoff for frank deficiency (IOM, 2000